Provider Demographics
NPI:1326780719
Name:PREMIER RENAL CARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:PREMIER RENAL CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NINDU
Authorized Official - Middle Name:
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-331-4466
Mailing Address - Street 1:421 PORTAGE TRL STE A
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3227
Mailing Address - Country:US
Mailing Address - Phone:330-331-4466
Mailing Address - Fax:330-926-3599
Practice Address - Street 1:421 PORTAGE TRL STE A
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3227
Practice Address - Country:US
Practice Address - Phone:330-331-4466
Practice Address - Fax:330-926-3599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZN0300XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherNephrologyGroup - Single Specialty