1932389749 NPI number — RENAL NUTRITION CONSULTANTS INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932389749 NPI number — RENAL NUTRITION CONSULTANTS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RENAL NUTRITION CONSULTANTS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932389749
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 439
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND BLANC
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48480-0439
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-923-5600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5080 VILLA LINDE PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48532-3423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-720-0162
Provider Business Practice Location Address Fax Number:
810-720-0301
Provider Enumeration Date:
11/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PIEPER
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
RENAL DIETITIAN
Authorized Official Telephone Number:
810-923-5600

Provider Taxonomy Codes

  • Taxonomy code: 133VN1005X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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