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NPI Code Detail

MEDICARE: RENAL TREATMENT CENTERS SOUTHEAST LP

MEDICARE: RENAL TREATMENT CENTERS SOUTHEAST LP
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

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 : 1962479386
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENAL TREATMENT CENTERS SOUTHEAST LP
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 : 615-341-6475
Fax Number : 877-699-0751
Provider Business Practice Location Address
First Line : 211 N 1ST ST
Second Line :
City : LEESBURG
State : FL
Zip : 34748-5150
Country : US
Telephone Number : 352-326-8100
Fax Number : 352-326-8307
Authorized Official
Title or Position : CHIEF ACCOUNTING OFFICER
Name : JAMES K HILGER
Credential :
Telephone Number : 253-733-4500
Provider Enumeration Date : 03/03/2006
Last Update Date : 03/13/2015

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