Organization
RENAL TREATMENT CENTERS MID ATLANTIC INC
Active
Other names
Forest Park 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
380 FOREST PKWY STE C, FOREST PARK, GA 30297-2107
(404) 361-0646
(404) 361-0727
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
ESRD001186
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000905374A
—
GA
05
—
1791628
—
LA
Enumeration date
03/14/2006
Last updated
10/21/2025
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