Organization
LIBERTY RC INC
Active
Other names
Southtowns Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (ASSISTANT SECRETARY)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4910 CAMP RD, STE 100, HAMBURG, NY 14075-2617
(716) 649-4072
(716) 649-1937
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
—
03335568
—
NY
Enumeration date
08/30/2010
Last updated
11/13/2025
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