RAI CARE CENTERS OF MICHIGAN I LLC NPI 1518051952

NPI Information

NPI: 1518051952
Provider Name: RAI CARE CENTERS OF MICHIGAN I, LLC

Doing Business As: FMC-CLYDE PARK DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
4893 CLYDE PARK AVE SW
WYOMING, MI
ZIP 49509
Phone: (616) 531-5353
Get Directions

RAI CARE CENTERS OF MICHIGAN I, LLC is an end-stage renal disease (esrd) treatment clinic center in Wyoming, MI. RAI CARE CENTERS OF MICHIGAN I, LLC NPI is 1518051952. The provider is registered as an organization entity type.
The provider Is Doing Business As Fmc-clyde Park Dialysis.

The provider's business location address is:

4893 CLYDE PARK AVE SW
WYOMING, MI
ZIP 49509-117
Phone: (616) 531-5353
Fax: (616) 531-5377

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 23D0959300 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 10/17/2023.

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	09446	OTHER	MICHIGAN	BCBS
2	404836121	MEDICAID	MICHIGAN
3	08949	OTHER	MICHIGAN	BCBS

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

NPI Synchronization or Removal

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