Organization
RENALSOUTH OF LOUISIANA, LLC
Active
Other names
RenalSouth of St. Tammany
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOMMY JAY CARTER (CEO)
(205) 943-6700
Entity
Organization
Contact information
Practice address
397 HIGHWAY 21, SUITE 602, MADISONVILLE, LA 70447-3407
(985) 792-5334
(985) 792-5234
Mailing address
2800 MILAN CT, SUITE 213, BIRMINGHAM, AL 35211-6912
(205) 943-6700
(205) 943-6697
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
145
LA
Other
Enumeration date
07/14/2005
Last updated
08/22/2020
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