Healthcare Provider Details

I. General information

NPI: 1891252250
Provider Name (Legal Business Name): REMOTE RENAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 INSPERON DR
GROVETOWN GA
30813-0607
US

IV. Provider business mailing address

401 INSPERON DR
GROVETOWN GA
30813-0607
US

V. Phone/Fax

Practice location:
  • Phone: 833-543-6398
  • Fax: 586-204-0125
Mailing address:
  • Phone: 833-543-6398
  • Fax: 586-204-0125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHARICA BROOKINS
Title or Position: OWNER
Credential:
Phone: 833-543-6398