Organization Name: | RELIANT RENAL CARE-COLORADO, LLC |
NPI Number: | 1285795443 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARBARA A BEDNAR (CEO) |
Mailing Address: | 400 Benedicta Ave C Trinidad |
State: | CO US |
Postal Code: | 810822099 |
Phone Number: | 7198450003 |
Fax Number: | 7198450011 |
NPI Enumeration Date: | 12/12/2006 |
NPI Last Update Date: | 06/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | 0280 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |