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NPI Code Detail

MEDICARE: RCG UNIVERSITY DIVISION, INC.

MEDICARE: RCG UNIVERSITY DIVISION, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1902918725
Entity Type Code : Organization
Provider Name (Legal Business Name) : RCG UNIVERSITY DIVISION, INC.
Provider Business Mailing Address
First Line : 16 POWDERHORN RD
Second Line :
City : SIMPSONVILLE
State : SC
Zip : 29681-3399
Country : US
Telephone Number : 864-962-2222
Fax Number : 864-228-4838
Provider Business Practice Location Address
First Line : 16 POWDERHORN RD
Second Line :
City : SIMPSONVILLE
State : SC
Zip : 29681-3399
Country : US
Telephone Number : 864-962-2222
Fax Number : 864-228-4838
Authorized Official
Title or Position : TREASURER
Name : MARK FAWCETT
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 08/31/2006
Last Update Date : 11/16/2009

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