RENAL CENTER OF MOUNTAIN HOME LLC NPI 1629015979

NPI Information

RENAL CENTER OF MOUNTAIN HOME LLC is an end-stage renal disease (esrd) treatment clinic center in Mountain Home, AR. RENAL CENTER OF MOUNTAIN HOME LLC NPI is 1629015979. The provider is registered as an organization entity type.
The provider Is Doing Business As Renal Center Of Mountain Home.

The provider's business location address is:

200 E 8TH ST STE 101
MOUNTAIN HOME, AR
ZIP 72653-402
Phone: (870) 508-6500
Fax: (870) 508-6550

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 04D1034072 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/2/2006 and was last updated on 6/16/2021.

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:

Other Identifiers

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