Organization
RENAL TREATMENT CENTERS-ILLINOIS INC
Active
Other names
Harlan Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2802 12TH ST, HARLAN, IA 51537-2303
(319) 472-7235
(319) 472-7236
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
—
0625285
—
IA
Enumeration date
03/01/2006
Last updated
04/17/2025
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