Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
Brewton Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1023 DOUGLAS AVE STE 300, BREWTON, AL 36426-1568
(251) 867-8509
(251) 867-7325
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
S2704
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156807
—
AL
Enumeration date
11/15/2012
Last updated
04/08/2024
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