Provider Demographics
NPI:1679688428
Name:RCG INDIANA LLC
Entity Type:Organization
Organization Name:RCG INDIANA LLC
Other - Org Name:FRESENIUS MEDICAL CARE CONNERSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:6049 INDUSTRIAL AVE N
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-7713
Mailing Address - Country:US
Mailing Address - Phone:765-827-1225
Mailing Address - Fax:765-827-1251
Practice Address - Street 1:6049 INDUSTRIAL AVE N
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-7713
Practice Address - Country:US
Practice Address - Phone:765-827-1225
Practice Address - Fax:765-827-1251
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-20
Last Update Date:2023-10-16
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
152586Medicare Oscar/Certification