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Organization

RENAL TREATMENT CENTERS MID ATLANTIC INC.

Active
Other names
Southern Tide Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
7525 TIDEWATER DR STE 37, NORFOLK, VA 23505-3700
(757) 852-0518
(757) 852-0543
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569

Taxonomy

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

Other

Enumeration date
05/18/2020
Last updated
08/06/2025
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