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NPI Code Detail

MEDICARE: RENAL CARE GROUP OF THE ROCKIES, LLC

MEDICARE: RENAL CARE GROUP OF THE ROCKIES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1124188248
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENAL CARE GROUP OF THE ROCKIES, LLC
Provider Business Mailing Address
First Line : 962 POTOMAC CIR
Second Line :
City : AURORA
State : CO
Zip : 80011-6714
Country : US
Telephone Number : 303-340-1398
Fax Number : 303-340-3214
Provider Business Practice Location Address
First Line : 962 POTOMAC CIR
Second Line :
City : AURORA
State : CO
Zip : 80011-6714
Country : US
Telephone Number : 303-340-1398
Fax Number : 303-340-3214
Authorized Official
Title or Position : VICE PRESIDENT
Name : BARRY L. BLANTON
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 12/11/2006
Last Update Date : 10/16/2023

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