Provider Demographics
NPI:1740344597
Name:RENAL CARE CONSULTANTS PC
Entity type:Organization
Organization Name:RENAL CARE CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:STEENKOLK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-842-9410
Mailing Address - Street 1:760 GOLF VIEW DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504
Mailing Address - Country:US
Mailing Address - Phone:541-618-4400
Mailing Address - Fax:541-618-4406
Practice Address - Street 1:760 GOLF VIEW DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-618-4400
Practice Address - Fax:541-618-4406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR104680Medicare UPIN