RENAL TREATMENT CENTERS - SOUTHEAST LP (NPI# 1396178471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396178471 |
| Entity Type | Organization |
| Organization Name | RENAL TREATMENT CENTERS - SOUTHEAST LP |
| Other Organization Name | SOUTH LITTLE ROCK DIALYSIS |
| Practice Address |
6115 Baseline Rd Ste 100 Little Rock AR 72209 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 5015700543 |
| Practice Fax Number | 5015700738 |
| Mailing Telephone | 6153204268 |
| Mailing Fax Number | 8772380567 |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2020-04-14 |
| Authorized Official Name | JOHN WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 208041134 | 05 |
| Other Name | Type Code |
|---|---|
| South Little Rock Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083137848 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 2110 N Galloway Ave Ste 102, Mesquite, TX 75150-5736 | 2017-07-24 |
| 1235360900 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 216 Hester Parker Dr, Marked Tree, AR 72365-2023 | 2009-07-29 |
| Street Address |
6115 BASELINE RD STE 100 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386280527 | Tiffany Williams | Counselor | 9914 I-30 Frontage, Little Rock, AR 72209 | 2019-11-22 |
| 1659913861 | Jerry Dean Swiney | Technician | 8401 Community Road, Little Rock, AR 72209 | 2019-10-09 |
| 1720501307 | A2z Therapy of Little Rock | Clinic/Center | 10702 Warren Dr, Little Rock, AR 72209 | 2017-07-25 |
| 1235582560 | Elite Medical Care, LLC | Respiratory Therapist, Registered | 11701 Interstate 30 Ste 100, Little Rock, AR 72209 | 2016-07-21 |
| 1154772127 | Aminah Henderson | Case Manager/Care Coordinator | 9914 I-30 Frontage Rd., Little Rock, AR 72209 | 2016-06-30 |
| 1295151504 | Properly Aligned LLC | Chiropractor | 7117 Geyer Springs, Little Rock, AR 72209 | 2014-03-11 |
| 1124378039 | Samuel Edward Adkins | Counselor | 9914 I-30 Frontage Road, Little Rock, AR 72209 | 2012-09-18 |
| 1073806790 | Gabrielle Stewart | Counselor | 9914 I-30 Frontage Rd, Little Rock, AR 72209 | 2011-05-27 |
| 1285951079 | Charles Jenson | Psychiatry & Neurology | 11321 Interstate 30 Ste 304, Little Rock, AR 72209 | 2010-05-03 |
| 1811144520 | Peace of Mind Child Care Center | Speech-Language Pathologist | 8919 Gardner Rd, Little Rock, AR 72209 | 2008-08-25 |
| Find all providers in zip 72209 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447640917 | Fidelity Home Dialysis Corporation | Clinic/Center | 9421 W Markham St, Little Rock, AR 72205-2240 | 2015-02-04 |
| 1609291202 | Little Rock Renal Services LLC | Clinic/Center | 1910 John Barrow Rd, Little Rock, AR 72204-1448 | 2014-02-19 |
| 1922346147 | Dialysis Clinic Inc. | Clinic/Center | 2800 W 10th St, Suite 510, Little Rock, AR 72204-2206 | 2013-01-23 |
| 1023313988 | Capes Dialysis LLC | Clinic/Center | 2 Lile Court, Ste 102-a, Little Rock, AR 72205-6241 | 2011-01-24 |
| 1376516039 | Dva Renal Healthcare Inc | Clinic/Center | 6 Freeway Dr, Suite 100, Little Rock, AR 72204-2486 | 2006-02-10 |
| 1679845580 | Bio-medical Applications of Arkansas, Inc. | Clinic/Center | 5320 W 12th St, Little Rock, AR 72204-1859 | 2012-02-08 |
| 1619274735 | Westside Dialysis Unit LLC | Clinic/Center | 1515 Kanis Park Dr, Suite A, Little Rock, AR 72205-4569 | 2011-02-25 |
| 1821100728 | Little Rock Dialysis Inc | Clinic/Center | 10310 W Markham St, Suite 100, Little Rock, AR 72205-2175 | 2006-08-31 |
| 1306876925 | Baptist Health | Clinic/Center | 9601 Baptist Health Drive, Little Rock, AR 72205 | 2006-07-03 |
| 1790728079 | St. Vincent Infirmary Medical Center | Clinic/Center | 2 Saint Vincent Cir, Little Rock, AR 72205-5423 | 2006-06-14 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72209 |
Please comment or provide details below to improve the information on RENAL TREATMENT CENTERS - SOUTHEAST LP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.