Organization
ISD RENAL INC
Active
Parent organization
DAVITA INC
Other names
Poplar Avenue Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVITA INC
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6691
Entity
Organization
Contact information
Practice address
1333 POPLAR AVE, MEMPHIS, TN 38104-2006
(901) 568-4465
Mailing address
5200 VIRGINIA WAY, ATTN LICENSURE & CERTIFICATION, BRENTWOOD, TN 37027-7569
(615) 946-1361
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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