Healthcare Provider Details

I. General information

NPI: 1710596309
Provider Name (Legal Business Name): REACH KIDNEY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 GRELOT RD STE C1
MOBILE AL
36609-3606
US

IV. Provider business mailing address

1633 CHURCH ST STE 500
NASHVILLE TN
37203-2948
US

V. Phone/Fax

Practice location:
  • Phone: 251-295-0667
  • Fax:
Mailing address:
  • Phone: 615-327-3061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DONOVAN SCHULTZ
Title or Position: PRESIDENT
Credential:
Phone: 615-327-3061