Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
Phenix City Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4391 RIVERCHASE DR, PHENIX CITY, AL 36867-7519
(334) 298-0294
(334) 298-3538
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
S5702
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003870445
—
AL
Enumeration date
04/13/2006
Last updated
01/16/2025
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