Organization
RENAL TREATMENT CENTERS MID ATLANTIC INC
Active
Other names
Shamokin Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
9333 STATE ROUTE 61, STE 1, COAL TOWNSHIP, PA 17866-4170
(570) 500-7072
(570) 500-7090
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103444602
—
PA
Enumeration date
06/09/2020
Last updated
07/16/2025
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