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NPI Code Detail

MEDICARE: RENAL CENTER OF TRENTON, LLC

MEDICARE: RENAL CENTER OF TRENTON, 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/Center007207NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699721993
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENAL CENTER OF TRENTON, LLC
Provider Business Mailing Address
First Line : 5200 VIRGINIA WAY
Second Line : L&C DEPT
City : BRENTWOOD
State : TN
Zip : 37027-7569
Country : US
Telephone Number : 615-341-6410
Fax Number : 888-662-8259
Provider Business Practice Location Address
First Line : 601 HAMILTON AVE
Second Line :
City : TRENTON
State : NJ
Zip : 08629-1915
Country : US
Telephone Number : 609-393-2388
Fax Number : 609-393-7927
Authorized Official
Title or Position : CHIEF ACCOUNTING OFFICER
Name : JOHN D WINSTEL
Credential :
Telephone Number : 253-733-4501
Provider Enumeration Date : 05/26/2006
Last Update Date : 04/03/2020

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