Organization · Type 2 NPI

Renal Care Group Arizona, LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Mammoth, AZ

NPI number 1104928373 Active

Practice location

14786 S State Highway 77
Mammoth, AZ 85618-0000

Fax (520) 487-0156

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

NPI record

NPI: 1104928373
Entity type: Organization (Type 2)
Issued: Sep 1, 2006
Last updated: Oct 17, 2023
Status: Active
Subpart: Yes of Fresenius Medical Care Holdings, Inc.

Other names

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Renal Care Group - Mammoth · doing business as
Renal Care Group - Mammoth · doing business as

Authorized official

Barry L. Blanton
Vice President
(781) 699-9000

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About NPI 1104928373

Renal Care Group Arizona, LLC's National Provider Identifier is 1104928373, issued on Sep 1, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Mammoth, AZ. The record was last updated on Oct 17, 2023.