RENAL CARE GROUP OF THE MIDWEST INC NPI 1861504664

NPI Information

NPI: 1861504664
Provider Name: RENAL CARE GROUP OF THE MIDWEST INC

Doing Business As: RCG PONCA CITY

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1208 E HARTFORD AVE
PONCA CITY, OK
ZIP 74601
Phone: (580) 718-9357
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RENAL CARE GROUP OF THE MIDWEST INC is an end-stage renal disease (esrd) treatment clinic center in Ponca City, OK. RENAL CARE GROUP OF THE MIDWEST INC NPI is 1861504664. The provider is registered as an organization entity type.
The provider Is Doing Business As Rcg Ponca City.

The provider's business location address is:

1208 E HARTFORD AVE
PONCA CITY, OK
ZIP 74601-017
Phone: (580) 718-9357
Fax: (580) 718-9421

The provider's authorized official is Mark R Fawcett .
The authorized official title is Treasurer and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 37D0967301 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 3/30/2011.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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
1	372552	MEDICARE OSCAR/CERTIFICATION	OKLAHOMA

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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