institution
Nra-hollywood, South Carolina, Llc
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ravenel, South Carolina
NPI 1356384069

Nra-hollywood, South Carolina, Llc is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center based in Ravenel, SC and is specialized in End-Stage Renal Disease (ESRD) Treatment. Nra-hollywood, South Carolina, Llc practices in Ravenel, SC. The NPI Number for Nra-hollywood, South Carolina, Llc is 1356384069 and holds a License No. ERD-157 (South Carolina).

The current practice location address for Nra-hollywood, South Carolina, Llc is 5953 Jacobs Point Blvd, Ravenel, SC and can be reached out via phone at 843-571-4025 and via fax at 843-571-4015.

Location: 5953 Jacobs Point Blvd, Ravenel, SC, 29470-5643
institution
Provider Profile Details
NPI Number
1356384069
Provider Name
Nra-hollywood, South Carolina, Llc
Credential
Provider Entity Type
Organization
Address
5953 Jacobs Point Blvd, Ravenel, SC, 29470-5643
Phone Number
843-571-4025
Fax Number
843-571-4015
Provider Enumeration Date
06/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
ERD-157 05 SC
42D1052012 01 SC CLIA CERTIFICATE OF WAIVE
institution
Provider Business Practice Location Address Details
Address
5953 Jacobs Point Blvd
City
State
Zip
29470-5643
Phone Number
843-571-4025
Fax Number
843-571-4015
person
Provider Business Mailing Address Details
Address
5953 Jacobs Point Blvd
City
State
Zip
29470-5643
Phone Number
843-571-4025
Fax Number
843-571-4015
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
End-Stage Renal Disease (ESRD) Treatment
Taxonomy
License No.
ERD-157 (South Carolina)
Definition
Definition to come...
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