Organization
PISCATA DIALYSIS LLC
Active
Other names
Forest Acres 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
4450 ROSEWOOD DR, COLUMBIA, SC 29209-2629
(803) 695-3214
(803) 695-3210
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
—
RE0097
—
SC
Enumeration date
10/21/2019
Last updated
02/26/2026
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