Redrock Renal Care LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

2000116.426 Issued in NV

Legal business name

REDROCK RENAL CARE LLC

Practice address

5751 S Fort Apache Rd
Suite 110
Las Vegas, NV 89148-5624

Phone

(702) 586-0007

Fax

(702) 586-0009

NPI assigned

Aug 18, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Galen Robert Bennett, BSBA

Title

Ceo / Administrator

Phone

(702) 586-0007

Specialties & licenses 1

Addresses

Tax ID family

Redrock Renal Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Redrock Renal Care LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Las Vegas, NV
  • NPI 1659559995
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rachakonda D Prabhu, M.D.

  • Pulmonary Disease Physician
  • Las Vegas, NV
  • NPI 1538156633
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1326294729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 S FORT APACHE RD",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485624",
            "telephone_number": "702-586-0007",
            "fax_number": "702-586-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 S FORT APACHE RD",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485624",
            "telephone_number": "702-586-0007",
            "fax_number": "702-586-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDROCK RENAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "GALEN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CEO / ADMINISTRATOR",
        "authorized_official_telephone_number": "702-586-0007",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSBA"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NV",
            "license": "2000116.426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Virginia Redmond, LCSW
• Eloiza Redondo
• Eugenia L Redonet
• Emily Redpath, DPT
• Redrock Chiropractic Inc (RedRock Chiropractic)
• Redrock Renal Care LLC
• Redrock Renal Group
• Redrock Renal Group LLC
• Stephanie L Redwine, RDH, BS
• Lamija Redzic

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.