Organization
ISD RENAL INC
Active
Other names
North Providence Renal Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1635 MINERAL SPRING AVE, NORTH PROVIDENCE, RI 02904-4025
(401) 354-5340
(401) 353-7020
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
KDT00741
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174579
—
RI
Enumeration date
05/26/2006
Last updated
11/05/2025
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