Organization
ISD RENAL INC
Active
Other names
Harrisonville Renal 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
308 GALAXIE AVE, HARRISONVILLE, MO 64701-2084
(816) 380-2004
(816) 380-7692
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6264
(800) 297-2925
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
—
1811943756
—
MO
Enumeration date
05/25/2006
Last updated
12/19/2023
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