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RENAL TREATMENT CENTERS - ILLINOIS INC NPI 1750343646


NPI Information

NPI: 1750343646
Provider Name: RENAL TREATMENT CENTERS - ILLINOIS INC

Doing Business As: FOWLERVILLE DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
206 E GRAND AVE
FOWLERVILLE, MI
ZIP 48836
Phone: (517) 223-0770
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RENAL TREATMENT CENTERS - ILLINOIS INC is an end-stage renal disease (esrd) treatment clinic center in Fowlerville, MI. RENAL TREATMENT CENTERS - ILLINOIS INC NPI is 1750343646. The provider is registered as an organization entity type.
The provider Is Doing Business As Fowlerville Dialysis.

The provider's business location address is:

206 E GRAND AVE
FOWLERVILLE, MI
ZIP 48836-128
Phone: (517) 223-0770
Fax: (517) 223-0208

The provider's authorized official is Thomas O Usilton .
The authorized official title is Group Vice President and has the following contact phone number (770) 541-7922.

The enumeration date for this NPI number is 4/5/2006 and was last updated on 7/17/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14511206MEDICAIDMICHIGAN
2232603MEDICARE OSCAR/CERTIFICATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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