Organization
FARRAGUT DIALYSIS, LLC
Active
Other names
Monarch 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
2958 DORCHESTER DR, MONTGOMERY, AL 36116-3193
(334) 280-4980
(334) 280-1809
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
S5112
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154843
—
AL
Enumeration date
03/22/2013
Last updated
09/11/2024
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