Organization
PLATTE DIALYSIS LLC
Active
Other names
Tahlequah Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1373 E BOONE ST, TAHLEQUAH, OK 74464-3364
(918) 431-0665
(918) 431-0623
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
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
—
200296340A
—
OK
Enumeration date
10/15/2009
Last updated
08/16/2023
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