Provider Demographics
NPI:1124246814
Name:AMERICAN RENAL CARE INC
Entity type:Organization
Organization Name:AMERICAN RENAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER ACCOUNT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:POULSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-344-6889
Mailing Address - Street 1:8745 COBBLESTONE POINT CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-4440
Mailing Address - Country:US
Mailing Address - Phone:678-344-6889
Mailing Address - Fax:
Practice Address - Street 1:1999 PARKER CT
Practice Address - Street 2:SUITE B
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3474
Practice Address - Country:US
Practice Address - Phone:678-344-6889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4733720001Medicare NSC