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General NPI Number Information
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NPI Number | 1518361989
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Entity Type | Organization
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Legal Business Name | USRC WINDER, LLC
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 429 LOGANVILLE HWY STE 105-109
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City | WINDER
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State | GA
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Zip | 30680
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Country | US
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Telephone | 678-425-9568
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Fax | 678-963-0499
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Provider Business Mailing Address
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Address Line | PO BOX 844631
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City | DALLAS
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State | TX
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Zip | 75284-4631
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Country | US
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Telephone | 214-736-2700
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Fax | 214-736-2690
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT
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Name | THOMAS L WEINBERG
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Credential |
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Telephone | 214-736-2700
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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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