NPI Record of RRC BESSEMER HOME (RELIANT RENAL CARE BESSEMER HOME CHOICE LLC) NPI 1437586641

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) in Bessemer, AL

Complete NPI Record

Field Name Value Definition
NPI1437586641The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameRELIANT RENAL CARE BESSEMER HOME CHOICE LLCThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization NameRRC BESSEMER HOMEOther name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address1400 N PROVIDENCE RDThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing AddressBLD II SUITE 1040The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City NameMEDIAThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NamePAThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code190632043The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number6108924700The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number6108929760The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address650 9TH AVE N.The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameBESSEMERThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameALThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code35020The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number6108924700The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6108929760The fax number associated with the location address of the provider being identified.
Provider Enumeration Date10/2/2013The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date5/17/2016The date that a record was last updated or changed.
Authorized Official Last NameMC MULLENThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameNOLAThe first name of the authorized official.
Authorized Official Title or PositionCOOThe title or position of the authorized official.
Authorized Official Telephone Number3072877640The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1261QE0700XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Is Organization SubpartY
Parent Organization LBNRELIANT RENAL CARE, INC
Parent Organization TINUNAVAIL