Provider Demographics
NPI:1700112034
Name:ACUTE RENAL CARE INC
Entity Type:Organization
Organization Name:ACUTE RENAL CARE INC
Other - Org Name:PREMIUM CARE DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:NAOMI
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-434-7233
Mailing Address - Street 1:PO BOX 24474
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77229-4474
Mailing Address - Country:US
Mailing Address - Phone:281-426-4300
Mailing Address - Fax:281-426-2900
Practice Address - Street 1:400 W OAK ST
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:TX
Practice Address - Zip Code:77562-2850
Practice Address - Country:US
Practice Address - Phone:281-426-4300
Practice Address - Fax:281-426-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016408251E00000X, 261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016408OtherTEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES