Organization Name: | RENAL TREATMENT CENTERS - ILLINOIS INC |
NPI Number: | 1750343646 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS O USILTON (GROUP VICE PRESIDENT) |
Mailing Address: | 206 E Grand Ave Fowlerville |
State: | MI US |
Postal Code: | 488360128 |
Phone Number: | 5172230770 |
Fax Number: | 5172230208 |
NPI Enumeration Date: | 04/05/2006 |
NPI Last Update Date: | 07/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |