Provider Demographics
NPI:1376552331
Name:RAI CARE CENTERS OF NORTH CAROLINA II, LLC
Entity Type:Organization
Organization Name:RAI CARE CENTERS OF NORTH CAROLINA II, LLC
Other - Org Name:RAI-WEST COLLEGE-WARSAW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:213 WEST COLLEGE STREET
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NC
Mailing Address - Zip Code:28398-1811
Mailing Address - Country:US
Mailing Address - Phone:910-293-9984
Mailing Address - Fax:910-293-9988
Practice Address - Street 1:213 WEST COLLEGE STREET
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NC
Practice Address - Zip Code:28398-1811
Practice Address - Country:US
Practice Address - Phone:910-293-9984
Practice Address - Fax:910-293-9988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-07
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3412630Medicaid
NC7516890OtherAETNA
NC9643911OtherCIGNA HEALTHCARE
NC001G3OtherBCBS
NC001G3OtherBCBS