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RENAL TREATMENT CENTERS-SOUTHEAST LP. NPI 1336483478


NPI Information

NPI: 1336483478
Provider Name: RENAL TREATMENT CENTERS-SOUTHEAST, LP.

Doing Business As: BREWTON DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 01D2054751

Address:
1023 DOUGLAS AVE STE 300
BREWTON, AL
ZIP 36426
Phone: (251) 867-8509
Get Directions

RENAL TREATMENT CENTERS-SOUTHEAST, LP. is an end-stage renal disease (esrd) treatment clinic center in Brewton, AL. RENAL TREATMENT CENTERS-SOUTHEAST, LP. NPI is 1336483478. The provider is registered as an organization entity type.
The provider Is Doing Business As Brewton Dialysis.

The provider's business location address is:

1023 DOUGLAS AVE STE 300
BREWTON, AL
ZIP 36426-568
Phone: (251) 867-8509
Fax: (251) 867-7325

The provider's authorized official is Samuel Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 01D2054751 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2012 and was last updated on 4/8/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentS2704ALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1156807MEDICAIDALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.