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RENAL TREATMENT CENTERS MID ATLANTIC INC NPI 1275597429


NPI Information

NPI: 1275597429
Provider Name: RENAL TREATMENT CENTERS MID ATLANTIC INC

Doing Business As: GREATER PORTSMOUTH

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 49D1013341

Address:
3110 HIGH ST
PORTSMOUTH, VA
ZIP 23707
Phone: (757) 530-7461
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RENAL TREATMENT CENTERS MID ATLANTIC INC is an end-stage renal disease (esrd) treatment clinic center in Portsmouth, VA. RENAL TREATMENT CENTERS MID ATLANTIC INC NPI is 1275597429. The provider is registered as an organization entity type.
The provider Is Doing Business As Greater Portsmouth.

The provider's business location address is:

3110 HIGH ST
PORTSMOUTH, VA
ZIP 23707-427
Phone: (757) 530-7461
Fax: (757) 530-7486

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

The CLIA number assigned to this NPI record is 49D1013341 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/14/2006 and was last updated on 5/23/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1010024293MEDICAIDVIRGINIA

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: 4/28/2024

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