Provider Demographics
NPI:1306392261
Name:USRC CASPER, LLC
Entity Type:Organization
Organization Name:USRC CASPER, LLC
Other - Org Name:U.S. RENAL CARE CASPER DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2730
Mailing Address - Street 1:5851 LEGACY CIR
Mailing Address - Street 2:SUITE 900
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5966
Mailing Address - Country:US
Mailing Address - Phone:214-736-2700
Mailing Address - Fax:214-736-2701
Practice Address - Street 1:1300 VENTURE WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4353
Practice Address - Country:US
Practice Address - Phone:307-265-2878
Practice Address - Fax:307-472-2019
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.S. RENAL CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment