Organization
RENAL TREATMENT CENTERS - SOUTHEAST LP
Active
Other names
Marked Tree Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
216 HESTER PARKER DR, MARKED TREE, AR 72365-2023
(870) 358-1130
(870) 358-1135
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6376
(877) 471-9926
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
01
—
04D1105591
CLIA
AR
05
—
193228134
—
AR
Enumeration date
07/29/2009
Last updated
10/16/2014
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