Provider Demographics
NPI:1427553510
Name:APPLE RENAL CARE LLC
Entity Type:Organization
Organization Name:APPLE RENAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHAT
Authorized Official - Middle Name:OMWENO
Authorized Official - Last Name:KIROCHI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-449-7705
Mailing Address - Street 1:5784 JILLIAN WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0418
Mailing Address - Country:US
Mailing Address - Phone:817-449-7705
Mailing Address - Fax:
Practice Address - Street 1:5784 JILLIAN WAY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052
Practice Address - Country:US
Practice Address - Phone:817-449-7705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX846625163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysisGroup - Single Specialty