Healthcare Provider Details

I. General information

NPI: 1245245471
Provider Name (Legal Business Name): NATIONAL MEDICAL CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9835 LAKE WORTH RD RCC OF WELLINGTON, CKD SERVICES
LAKE WORTH FL
33467-2300
US

IV. Provider business mailing address

920 WINTER ST FMCNA CKD SERVICES
WALTHAM MA
02451-1521
US

V. Phone/Fax

Practice location:
  • Phone: 561-969-7799
  • Fax: 561-969-1175
Mailing address:
  • Phone: 781-699-4160
  • Fax: 781-699-4046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK FAWCETT
Title or Position: TREASURER
Credential:
Phone: 781-699-2668