Organization
PRESCOTT RENAL CARE GROUP, LLC
Active
Other names
RENAL CARE GROUP PRESCOTT
Organization subpart
No
Provider details
NPI number
Authorized official
MARK FAWCETT (TREASURER)
(781) 402-9000
Entity
Organization
Contact information
Practice address
13175 E HIGHWAY 169, DEWEY, AZ 86327-7372
(928) 713-5122
Mailing address
13175 E HIGHWAY 169, DEWEY, AZ 86327-7372
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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