TOTAL RENAL CARE OF NORTH CAROLINA LLC NPI 1912307596

NPI Information

NPI: 1912307596
Provider Name: TOTAL RENAL CARE OF NORTH CAROLINA LLC

Doing Business As: NEW RIVER DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 34D2089210

Address:
111 YOPP ROAD
JACKSONVILLE, NC
ZIP 28540
Phone: (910) 989-0157
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TOTAL RENAL CARE OF NORTH CAROLINA LLC is an end-stage renal disease (esrd) treatment clinic center in Jacksonville, NC. TOTAL RENAL CARE OF NORTH CAROLINA LLC NPI is 1912307596. The provider is registered as an organization entity type.
The provider Is Doing Business As New River Dialysis.

The provider's business location address is:

111 YOPP ROAD
JACKSONVILLE, NC
ZIP 28540-509
Phone: (910) 989-0157
Fax: (910) 989-0328

The provider's authorized official is John D Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 34D2089210 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/2/2014 and was last updated on 10/28/2022.

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		NORTH CAROLINA	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	1912307596	MEDICAID	NORTH CAROLINA

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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