Organization
TETONA DIALYSIS, LLC
Active
Other names
Gentilly 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
4720 PARIS AVE, NEW ORLEANS, LA 70122-2553
(504) 283-9098
(504) 282-3888
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, 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
—
2484443
—
LA
Enumeration date
02/02/2016
Last updated
05/21/2024
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