Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
South Arkansas 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
620 W GROVE ST, EL DORADO, AR 71730-4462
(870) 862-8788
(870) 862-5756
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
—
198755134
—
AR
Enumeration date
11/21/2012
Last updated
05/04/2026
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