Provider Demographics
NPI:1609892579
Name:RENAL CARE ASSOCIATES PC
Entity Type:Organization
Organization Name:RENAL CARE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:LUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-327-6265
Mailing Address - Street 1:2121 N BEVERLY AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2154
Mailing Address - Country:US
Mailing Address - Phone:520-327-6265
Mailing Address - Fax:520-327-9300
Practice Address - Street 1:2121 N BEVERLY AVE
Practice Address - Street 2:STE 105
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2154
Practice Address - Country:US
Practice Address - Phone:520-327-6265
Practice Address - Fax:520-327-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
66300Medicare ID - Type Unspecified