Organization
TENNESSEE VALLEY DIALYSIS CENTER LLC
Active
Other names
Tennessee Valley 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
107 WOODLAWN DR, STE 2, JOHNSON CITY, TN 37604-6287
(423) 926-2976
(423) 926-1232
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
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
—
0442666
—
TN
Enumeration date
05/24/2006
Last updated
11/28/2023
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