Organization
LIBERTY RC INC
Active
Other names
Niagara Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2932 MILITARY RD, NIAGARA FALLS, NY 14304-1252
(716) 297-4059
(716) 297-4969
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
—
04103513
—
NY
Enumeration date
08/29/2014
Last updated
12/06/2024
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