Organization
ISD RENAL INC
Active
Other names
Whitehaven Renal Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3420 ELVIS PRESLEY BLVD, MEMPHIS, TN 38116-3260
(901) 396-3794
(901) 396-9286
Mailing address
5200 VIRGINIA WAY, 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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442655
—
TN
Enumeration date
05/26/2006
Last updated
02/11/2026
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