| NPI | 1144283185 |
|---|---|
| Doing Business As | FOURTH STREET DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | SAMUEL T WEY VP Licensure&Certification 615-341-6641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: TX 007783) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2024-08-22 |