Healthcare Provider Details
I. General information
NPI: 1275460438
Provider Name (Legal Business Name): RENALCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10004 KENNERLY RD STE 103A
SAINT LOUIS MO
63128-2173
US
IV. Provider business mailing address
PO BOX 18
FENTON MO
63026-0018
US
V. Phone/Fax
- Phone: 314-447-9600
- Fax: 314-447-9601
- Phone: 314-447-9600
- Fax: 314-447-9601
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RUO-QI
HU
Title or Position: MD/OWNER
Credential: MD
Phone: 618-210-7191