Organization
RENAL TREATMENT CENTERS-ILLINOIS INC
Active
Other names
South Lincoln Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3401 PLANTATION DRIVE, STE 140, LINCOLN, NE 68516-4712
(402) 421-6011
(402) 421-6052
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
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
—
10025469100
—
NE
Enumeration date
10/02/2006
Last updated
10/23/2023
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