Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
River Valley Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3121 W 2ND CT, RUSSELLVILLE, AR 72801-4504
(479) 968-4687
(479) 968-2260
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
—
200364134
—
AR
Enumeration date
11/26/2012
Last updated
11/13/2025
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