Organization
FLOR DIALYSIS LLC
Active
Other names
Magic City Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
300 22ND ST S, BIRMINGHAM, AL 35233-2209
(205) 986-0592
(205) 321-6682
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
S3731
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134278
—
AL
Enumeration date
02/16/2011
Last updated
11/08/2024
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