| NPI | 1801046255 |
|---|---|
| Doing Business As | PORT LAVACA DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | SAMUEL T WEY Sr Director Licensure&Certification 615-341-6641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment (Licence: TX 008733) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2023-08-24 |