Organization
RENAL TREATMENT CENTERS-ILLINOIS INC
Active
Other names
Omaha Harrison 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
6610 S 168TH ST, STE 8, OMAHA, NE 68135-5412
(402) 896-4609
(402) 896-1439
Mailing address
5200 VIRGINIA WAY, 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
—
10026218400
—
NE
Enumeration date
10/06/2011
Last updated
06/10/2024
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