Organization
RENAL TREATMENT CENTERS WEST INC
Active
Other names
Scottsbluff 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
820 W 42ND ST STE 1600, SCOTTSBLUFF, NE 69361-5017
(308) 220-3572
(308) 220-3592
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
ESRD017
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166123700
—
WY
05
—
17432383
—
CO
Enumeration date
04/03/2006
Last updated
05/16/2024
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