Organization
TOLTEC DIALYSIS LLC
Active
Other names
College City Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2630 DONAGHEY AVE, CONWAY, AR 72032-2308
(501) 504-2474
(501) 504-2611
Mailing address
5200 VIRGINIA WAY, L& C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
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
—
230940134
—
AR
Enumeration date
04/11/2018
Last updated
10/09/2023
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