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Organization

ISD RENAL INC

Active
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Organization

ISD RENAL INC

Active
Parent organization
DAVITA INC
Other names
Quince Road Dialysis
Organization subpart
Yes

Provider details

NPI number
Legal business name
DAVITA INC
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6691
Entity
Organization

Contact information

Practice address
6548 QUINCE RD, MEMPHIS, TN 38119-8211
(860) 690-2856
Mailing address
5200 VIRGINIA WAY, ATTN LICENSURE & CERTIFICATION, BRENTWOOD, TN 37027-7569
(615) 946-1361

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary

Other

Enumeration date
12/01/2025
Last updated
12/01/2025
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