Organization
LITTLE ROCK DIALYSIS CENTERS LLC
Active
Other names
Jacksonville Central Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
400 T P WHITE DR, JACKSONVILLE, AR 72076-3287
(501) 241-1300
(501) 985-1344
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
—
167213134
—
AR
Enumeration date
04/20/2007
Last updated
06/14/2024
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