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General NPI Number Information
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NPI Number | 1316983299
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Entity Type | Organization
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Legal Business Name | RENAL TREATMENT CENTERS SOUTHEAST LP
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 1525 LIME ST SUITE 120
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-3015
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Country | US
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Telephone | 904-491-1998
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Fax | 904-491-0006
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Provider Business Mailing Address
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Address Line | 5200 VIRGINIA WAY L&C DEPT
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City | BRENTWOOD
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State | TN
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Zip | 37027-7569
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Country | US
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Telephone | 615-238-3027
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Fax | 800-246-7584
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Authorized Official
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Title or Position | CHIEF ACCOUNTING OFFICER
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Name | JAMES K HILGER
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Credential |
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Telephone | 253-733-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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