Organization
RENAL TREATMENT CENTERS SOUTHEAST LP
Active
Other names
Amelia Island 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
1525 LIME ST, SUITE 120, FERNANDINA BEACH, FL 32034-3015
(904) 491-1998
(904) 491-0006
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3027
(800) 246-7584
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
—
890120100
—
FL
Enumeration date
06/21/2006
Last updated
10/05/2016
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