Provider Demographics
NPI:1669183729
Name:ESRD CHRONIC CARE MANAGEMENT INC
Entity type:Organization
Organization Name:ESRD CHRONIC CARE MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-729-5434
Mailing Address - Street 1:40 N ROBIN HOOD RD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-2042
Mailing Address - Country:US
Mailing Address - Phone:954-729-5434
Mailing Address - Fax:
Practice Address - Street 1:40 N ROBIN HOOD RD
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34450-2042
Practice Address - Country:US
Practice Address - Phone:954-729-5434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NICOLE JOYNER ESRD CONSULTING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management