Organization
RENAL TREATMENT CENTERS-ILLINOIS INC.
Active
Other names
Clarkston Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
6770 DIXIE HWY STE 205, CLARKSTON, MI 48346-2089
(248) 620-0958
(248) 620-1204
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
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
05
—
1710948211
—
MI
Enumeration date
05/06/2015
Last updated
07/19/2022
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