RENAL TREATMENT CENTERS SOUTHEAST LP (NPI# 1184968604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184968604 |
| Entity Type | Organization |
| Organization Name | RENAL TREATMENT CENTERS SOUTHEAST LP |
| Other Organization Name | DEGRAY DIALYSIS |
| Practice Address |
312 Professional Park Dr Ste H Arkadelphia AR 71923-5355 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 8702463021 |
| Practice Fax Number | 8702453766 |
| Mailing Telephone | 6153204268 |
| Mailing Fax Number | 8772380567 |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2020-09-03 |
| 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 | 201693134 | 05 |
| Other Name | Type Code |
|---|---|
| DeGray Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689176711 | Renal Treatment Centers Southeast Lp | Clinic/Center | 1510 Eastern Blvd, Montgomery, AL 36117-1629 | 2018-03-05 |
| 1376075523 | Renal Treatment Centers Southeast Lp | Clinic/Center | 2443 Monarch Dr, Laredo, TX 78045-6329 | 2017-03-28 |
| 1134667264 | Renal Treatment Centers Southeast Lp | Clinic/Center | 2860 Us Highway 83, Zapata, TX 78076 | 2017-02-09 |
| 1528517752 | Renal Treatment Centers Southeast Lp | Clinic/Center | 404 S Veterans Blvd, Ste D, Edinburg, TX 78539 | 2016-09-29 |
| 1902353543 | Renal Treatment Centers Southeast Lp | Clinic/Center | 1006 E Interstate Highway 2, Donna, TX 78537-4153 | 2016-09-01 |
| 1285087189 | Renal Treatment Centers Southeast Lp | Clinic/Center | 6626 Antoine Dr, Houston, TX 77091-1206 | 2016-07-15 |
| 1992134340 | Renal Treatment Centers Southeast Lp | Clinic/Center | 5406 Highway 280, Suite D107, Birmingham, AL 35242-6592 | 2013-11-06 |
| 1538503008 | Renal Treatment Centers Southeast Lp | Clinic/Center | 7580 Fannin St Ste 200, Houston, TX 77054-1900 | 2013-04-26 |
| 1881938207 | Renal Treatment Centers Southeast Lp | Clinic/Center | 115 Wrights St Ste A, Hot Springs, AR 71913-6240 | 2012-11-26 |
| 1891039210 | Renal Treatment Centers Southeast Lp | Clinic/Center | 1114 W Washington St Nw, Camden, AR 71701-3827 | 2012-11-26 |
| Street Address |
312 PROFESSIONAL PARK DR STE H |
| City | ARKADELPHIA |
| State | AR |
| Zip Code | 71923-5355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053512 | Lacey Griffin | Pharmacist | 109 Wp Malone Drive, Arkadelphia, AR 71923 | 2020-11-05 |
| 1528478955 | Baptist Health | Clinic/Center | 10 Montgomery Drive, Caddo Valley, AR 71923 | 2014-05-07 |
| 1770923724 | Amber Dawn Jones | Nurse Practitioner | 10 Montgomery Dr, Caddo Valley, AR 71923 | 2013-07-04 |
| 1699050872 | Timothy R Phelan | Pharmacist | 131 N 26 St, Walgreens, Arkadelphia, AR 71923 | 2011-10-19 |
| 1083924229 | Misty Cox | Health Educator | 2410 Pine Street, Arkadelphia, AR 71923 | 2010-10-20 |
| 1942433677 | James W. Hankins, D.d.s., P.a. | Dentist | 2840 Twin Rivers Dr., Arkadelphia, AR 71923 | 2009-08-28 |
| 1003027061 | William Coke Viser | Counselor | 94 Pinnacle Drive, Arkadelphia, AR 71923 | 2007-05-24 |
| 1184843773 | Renski Davis-buckley | Case Manager/Care Coordinator | 524 N. Clark, Arkadelphia, AR 71923 | 2007-04-24 |
| 1407988355 | State of Arkansas | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Prator Drive, Arkadelphia, AR 71923 | 2007-03-09 |
| 1003945734 | Danita Stubbs | Case Manager/Care Coordinator | 2607 Caddo Street, Arkadelphia, AR 71923 | 2007-03-06 |
| Find all providers in zip 71923 | ||||
| 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 |
|---|---|---|---|---|
| 1982679916 | Arkansas Nephrology Services, Ltd. | Clinic/Center | 312 Professional Park Dr, Suite H, Arkadelphia, AR 71923-5315 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092597 | Fort Smith Regional Dialysis Center, LLC | Clinic/Center | 256 Northridge Drive E, Van Buren, AR 72956 | 2020-08-06 |
| 1073010518 | Toltec Dialysis LLC | Clinic/Center | 2630 Donaghey Ave, Conway, AR 72032-0000 | 2018-04-11 |
| 1588102610 | Matheson Dialysis LLC | Clinic/Center | 9022 Landers Rd Ste E, North Little Rock, AR 72117-1599 | 2017-02-09 |
| 1871031211 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 115 E Peddicord St, Dermott, AR 71638-2314 | 2017-02-06 |
| 1821455494 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 505 Saint Mary St, Lake Village, AR 71653-1722 | 2016-01-27 |
| 1912399601 | Ozark Dialysis LLC | Clinic/Center | 404 Camp Rd, Pocahontas, AR 72455-1487 | 2015-03-04 |
| 1447640917 | Fidelity Home Dialysis Corporation | Clinic/Center | 9421 W Markham St, Little Rock, AR 72205-2240 | 2015-02-04 |
| 1386053296 | Arkansas Staff Assisted Hemodialysis,inc | Clinic/Center | 321 Terry Pond Cv, White Hall, AR 71602-8212 | 2014-08-05 |
| 1609291202 | Little Rock Renal Services LLC | Clinic/Center | 1910 John Barrow Rd, Little Rock, AR 72204-1448 | 2014-02-19 |
| 1396178471 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 6115 Baseline Rd, Ste 100, Little Rock, AR 72209 | 2013-08-13 |
| Find all providers with the same taxonomy | ||||
| City | ARKADELPHIA |
| Zip Code | 71923 |
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.