Renal Care Group Ft. Walton Beach

LBN: Renal Care Group Of The Southeast, Inc.
Renal Care Group Ft. Walton Beach is an health care organization with primary practice located at 925 Mar Walt Dr Ste 3 , Fort Walton Beach FL 32547-6609. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Renal Care Group Of The Southeast, Inc. can be contacted via phone (850) 864-4411, or through Blanton, Barry L. via phone (781) 699-9000.

Contact Information

Primary practice address
925 Mar Walt Dr Ste 3 Fort Walton Beach FL 32547-6609
Phone: (850) 864-4411
Fax: (850) 864-1279
Website:
Map and Directions
Authorized official contact:
Name: Blanton, Barry L.
Phone: (781) 699-9000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1447362280
LBN Legal business name Renal Care Group Of The Southeast, Inc.
DBA Doing business as Renal Care Group Ft. Walton Beach
Authorized official Blanton, Barry L.
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 31st, 2006
Last updated Oct 16th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447362280 NPPES
Florida MEDICAID 212067400

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