Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
Renaissance Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIR LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1840 DARBY DR, FLORENCE, AL 35630-2623
(256) 764-2313
(256) 764-2793
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
S3902
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508033614
—
AL
Enumeration date
05/08/2008
Last updated
10/11/2023
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