Organization
LONGWORTH DIALYSIS LLC
Active
Organization
LONGWORTH DIALYSIS LLC
Active
Other names
Greer South Home Training
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
3254 BRUSHY CREEK RD, STE A, GREER, SC 29650-1000
(864) 877-9157
(864) 801-2937
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ERD -0202
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RE0047
—
SC
Enumeration date
05/14/2012
Last updated
07/26/2023
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