Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
Talladega 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
726 BATTLE ST E, STE A, TALLADEGA, AL 35160-2583
(256) 362-2332
(256) 362-2356
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
S6106
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102673
—
AL
01
—
S6106
STATE LICENSE
AL
Enumeration date
09/18/2007
Last updated
05/19/2025
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