Provider Demographics
NPI:1790835031
Name:RAI CARE CENTERS OF COLTON, LLC
Entity Type:Organization
Organization Name:RAI CARE CENTERS OF COLTON, LLC
Other - Org Name:RAI - WEST C - COLTON
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 1:1275 W C ST
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-1916
Mailing Address - Country:US
Mailing Address - Phone:909-430-0930
Mailing Address - Fax:909-430-0934
Practice Address - Street 1:1275 W C ST
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-1916
Practice Address - Country:US
Practice Address - Phone:909-430-0930
Practice Address - Fax:909-430-0934
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-11
Last Update Date:2023-10-17
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
CA330760564OtherKAISER
CACDC02817HMedicaid
CA052817Medicare ID - Type Unspecified