Organization
RENAL TREATMENT CENTERS ILLINOIS INC
Active
Other names
Salem Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O USILTON JR. (SR VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
1201 N JIM DAY ROAD, STE 103, SALEM, IN 47167
(812) 883-0207
(812) 883-0130
Mailing address
5200 VIRGINIA WAY, STE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4435
(303) 209-7821
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
—
200879310A
—
IN
Enumeration date
02/22/2007
Last updated
04/22/2008
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