Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
Bogalusa Kidney Care
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2108 AVENUE F, BOGALUSA, LA 70427-5027
(985) 735-7811
(985) 735-1501
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
089
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06774703
—
MS
05
—
1543276
—
LA
Enumeration date
03/18/2006
Last updated
10/02/2025
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