Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
West Florida Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
8333 N DAVIS HWY, 1ST FLOOR ATTN DIALYSIS ROOM, PENSACOLA, FL 32514-6050
(850) 474-8424
(850) 969-2879
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
—
100024400
—
FL
Enumeration date
03/11/2006
Last updated
05/22/2024
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