Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
Chipley 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
877 3RD ST, STE 2, CHIPLEY, FL 32428-1855
(850) 638-7783
(850) 638-8550
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891353600
—
FL
Enumeration date
04/21/2006
Last updated
09/15/2025
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