Organization
RAI CARE CENTERS OF NORTH CAROLINA II, LLC
Active
Other names
RAI-Latrobe-Charlotte
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON M SUNDOCK (VICE PRESIDENT)
(615) 507-3307
Entity
Organization
Contact information
Practice address
3515 LATROBE DR, CHARLOTTE, NC 28211-4853
(704) 366-5299
(704) 366-7597
Mailing address
1550 W. MCEWEN DRIVE, SUITE 500, FRANKLIN, TN 37067-1731
(615) 661-1100
(615) 507-3300
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001G3
BCBS
NC
01
—
1703087
CIGNA HEALTHCARE
NC
05
—
3422552
—
NC
01
—
7997895
AETNA
NC
Enumeration date
08/05/2006
Last updated
02/10/2011
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