Healthcare Provider Details
I. General information
NPI: 1841267697
Provider Name (Legal Business Name): RENAL TREATMENT CENTERS WEST INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/01/2006
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
209 W COUNTY LINE RD
LITTLETON CO
80129-1901
US
IV. Provider business mailing address
5200 VIRGINIA WAY ATTN L&C DEPT
BRENTWOOD TN
37027-7569
US
V. Phone/Fax
- Phone: 303-730-7540
- Fax: 303-730-7628
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | 1204QL |
| License Number State | CO |
VIII. Authorized Official
Name:
SAMUEL
T
WEY
Title or Position: VP LICENSURE & CERTIFICATION
Credential:
Phone: 615-341-6641