Organization
MATTAPAN DIALYSIS LLC
Active
Other names
Riverdale Home Training
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
5144 RIVERDALE RD STE 103, MEMPHIS, TN 38141-0271
(901) 752-5425
(901) 752-5516
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
—
—
Other
Enumeration date
07/26/2019
Last updated
05/14/2025
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