Red Rocks Dialysis, LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Gallup, NM
NPI 1710137534 · NPPES record last updated Oct 25, 2013
Key facts
- NPI
- 1710137534
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- RED ROCKS DIALYSIS, LLC
- Practice address
- 725 Hospital Dr
Gallup, NM 87301-5611 - Phone
- (505) 863-3465
- Fax
- (505) 863-3205
- NPI assigned
- Sep 29, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- U.S. RENAL CARE, INC.
Authorized official
- Name
- Thomas L. Weinberg
- Title
- Authorized Official
- Phone
- (214) 736-2700
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 3
Affiliated clinicians 4
Medicare Care Compare: Dialysis facility
- Listed as
- Usrc Gallup Dialysis
- Overall star rating
- ★★★☆☆ 3.0 of 5
- Ownership
- Non-profit
- Certified
- Aug 31, 1977
- Medicare certification status
- Active
- Chain
- US Renal Care, Inc.
- Dialysis stations
- 37
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 32D0865913 | Red Rocks Dialysis LLC Dba U S Renal Care Gallup | Certificate of waiver | May 14, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090706000561 | NM | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 8325196066 | Practice locations: Gallup, NM |
National Provider Directory
- Tax ID family
- Red Rocks Dialysis LLC
- Part of
- US Renal Care Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
725 Hospital Dr
Gallup, NM 87301-5611
Mailing address
1 World Trade Ctr
Ste 2500
Long Beach, CA 90831-0002
Phone (562) 495-8075
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42107059 | Medicaid | NM |
Other names
- U.S Renal Care Gallup Dialysis
Other providers in Gallup, NM
- Roberta Rayburn
- Susan Kay Raymond
- RCT Homecare LLC
- Red Mesa Optical
- Red Rocks Care Center Opco, LLC
- Red Rocks Dialysis, LLC
- Red Rocks Nursing Operations, LLC
- Trudy R Redshirt
- Jacqueline Evon Reed
- Timothy Peter Reed
All providers in Gallup, NM · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2013. 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.