Organization Name: | RENAL TREATMENT CENTERS SOUTHEAST LP |
NPI Number: | 1811140767 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
Mailing Address: | 3947 Gulf Shores Pkwy Unit 150 Gulf Shores |
State: | AL US |
Postal Code: | 365422859 |
Phone Number: | 2519672205 |
Fax Number: | 2519672210 |
NPI Enumeration Date: | 10/23/2008 |
NPI Last Update Date: | 09/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | S0206 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |