RENAL TREATMENT CENTERS-SOUTHEAST LP. NPI 1508100017

NPI Information

NPI: 1508100017
Provider Name: RENAL TREATMENT CENTERS-SOUTHEAST, LP.

Doing Business As: SOUTH ARKANSAS DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
620 W GROVE ST
EL DORADO, AR
ZIP 71730
Phone: (870) 862-8788
Get Directions

RENAL TREATMENT CENTERS-SOUTHEAST, LP. is an end-stage renal disease (esrd) treatment clinic center in El Dorado, AR. RENAL TREATMENT CENTERS-SOUTHEAST, LP. NPI is 1508100017. The provider is registered as an organization entity type.
The provider Is Doing Business As South Arkansas Dialysis.

The provider's business location address is:

620 W GROVE ST
EL DORADO, AR
ZIP 71730-462
Phone: (870) 862-8788
Fax: (870) 862-5756

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.

The enumeration date for this NPI number is 11/21/2012 and was last updated on 1/17/2024.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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
1	198755134	MEDICAID	ARKANSAS

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

NPI Synchronization or Removal

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