Dca of Edgefield LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Edgefield, SC
NPI 1013966480 · NPPES record last updated Jun 21, 2018
Key facts
- NPI
- 1013966480
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- DCA OF EDGEFIELD LLC
- Practice address
- 306 Main Street
Edgefield, SC 29824-1326 - Phone
- (803) 637-3225
- Fax
- (803) 637-3229
- NPI assigned
- May 10, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- U S RENAL CARE INC
Authorized official
- Name
- Mr. Thomas L Weinberg
- Title
- Vice President & Secretary
- Phone
- (214) 736-2700
Affiliated clinicians 1
-
Sindhu Garg, MD
Medicare Care Compare: Dialysis facility
- Listed as
- USRC Edgefield
- Overall star rating
- ★★★★☆ 4.0 of 5
- Ownership
- Profit
- Certified
- Mar 20, 2006
- Medicare certification status
- Active
- Chain
- US Renal Care, Inc.
- Dialysis stations
- 15
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D1043551 | Dca of Edgefield, LLD Dba US Renal Care Edgefield | Certificate of waiver | Jul 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050810000878 | SC | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 3375572217 | Practice locations: Edgefield, SC |
National Provider Directory
Locations
306 Main St
Edgefield, SC 29824
Phone (803) 637-3225
Networks
- SC HMO
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
306 Main Street
Edgefield, SC 29824-1326
Mailing address
PO Box 19119
Jonesboro, AR 72403-6601
Phone (870) 931-5400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ERD149 | Medicaid | SC |
Other names
- U S Renal Care Edgefield Dialysis
Other providers in Edgefield, SC
- Carole Ann Chidley
- Matthew Wayne Cook
- Teri Lynn Cristal
- Kathy Heiss Culver
- Kenneth Davis
- Suzanne M Derrick
- Curran Ditmeyer
- Carla Dorn
- Dr. Jeffery R. Gosney
- Leah Miller Driver
All providers in Edgefield, SC · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.