Organization
RENAL TREATMENT CENTERS-SOUTHEAST LP
Active
Other names
White Bluff Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D. WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
505 US HIGHWAY 80 W STE F, DEMOPOLIS, AL 36732-4148
(334) 287-1254
(334) 287-1166
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, 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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180497
—
AL
Enumeration date
05/29/2014
Last updated
07/24/2023
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