Organization
ISD RENAL INC
Active
Other names
Renal Care of Marion
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1120 STATE HIGHWAY 77 STE 2, MARION, AR 72364-9046
(870) 735-4087
(870) 735-4062
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161607134
—
AR
Enumeration date
05/23/2006
Last updated
01/23/2025
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