Organization
RENAL TREATMENT CENTERS SOUTHEAST LP
Active
Other names
Andalusia Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
757 S THREE NOTCH ST, ANDALUSIA, AL 36420-4403
(334) 222-1628
(334) 222-2658
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
S2101
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141573
—
AL
Enumeration date
03/27/2012
Last updated
09/30/2020
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