Provider Demographics
NPI:1811964620
Name:RENAL TREATMENT CENTERS WEST INC
Entity type:Organization
Organization Name:RENAL TREATMENT CENTERS WEST INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF ACCOUNTING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:HILGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-733-4500
Mailing Address - Street 1:5200 VIRGINIA WAY
Mailing Address - Street 2:L&C DEPT
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7569
Mailing Address - Country:US
Mailing Address - Phone:615-341-6765
Mailing Address - Fax:833-782-9089
Practice Address - Street 1:850 E HARVARD AVE
Practice Address - Street 2:STE 60
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5030
Practice Address - Country:US
Practice Address - Phone:303-744-0559
Practice Address - Fax:303-744-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0844261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05258058Medicaid
062518Medicare Oscar/Certification