| NPI | 1811328784 |
|---|---|
| Doing Business As | SOUTH SHORE ANNEX 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 |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2023-12-13 |