Provider Demographics
NPI:1417982075
Name:RENAL CARE OF SEAT PLEASANT LLC
Entity Type:Organization
Organization Name:RENAL CARE OF SEAT PLEASANT LLC
Other - Org Name:RENAL CARE OF SEAT PLEASANT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:NATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-233-2781
Mailing Address - Street 1:5200 VIRGINIA WAY
Mailing Address - Street 2:L&C DEPT
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7569
Mailing Address - Country:US
Mailing Address - Phone:615-320-4214
Mailing Address - Fax:866-944-3352
Practice Address - Street 1:6274 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SEAT PLEASANT
Practice Address - State:MD
Practice Address - Zip Code:20743-6128
Practice Address - Country:US
Practice Address - Phone:301-336-6274
Practice Address - Fax:301-336-3946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDE2640261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4062469 00Medicaid
DC0362989 00Medicaid
MD4062469 00Medicaid