RENAL CARE GROUP WASILLA LLC NPI 1497867295

NPI Information

RENAL CARE GROUP WASILLA, LLC is an end-stage renal disease (esrd) treatment clinic center in Wasilla, AK. RENAL CARE GROUP WASILLA, LLC NPI is 1497867295. The provider is registered as an organization entity type.
The provider Is Doing Business As Renal Care Group Wasilla.

The provider's business location address is:

3787 E MERIDIAN LOOP
WASILLA, AK
ZIP 99654-270
Phone: (907) 357-5600
Fax: (907) 357-5661

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 02D1022169 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/19/2021.

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:

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