Organization
SOUTH SHORE DIALYSIS CENTER LP
Active
Other names
South Shore 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
212 GULF FWY S, STE G3, LEAGUE CITY, TX 77573-3956
(281) 554-6050
(281) 316-1385
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
008213
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183410302
—
TX
Enumeration date
04/17/2006
Last updated
03/19/2025
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