Organization
RAINER DIALYSIS LLC
Active
Other names
South City Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (SR DIR LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3740 S JEFFERSON AVE, SAINT LOUIS, MO 63118-3905
(314) 664-6687
(314) 772-1614
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6264
(800) 297-2925
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
—
1245580570
—
MO
Enumeration date
09/13/2012
Last updated
09/08/2023
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