Organization
ISD RENAL INC
Active
Other names
UNIVERSITY DIALYSIS OF INDY
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
550 UNIVERSITY BLVD RM 1140, INDIANAPOLIS, IN 46202-5149
(317) 635-8729
(317) 635-9512
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
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
—
300011902
—
IN
Enumeration date
06/05/2017
Last updated
12/20/2023
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