Renal Life Link INC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Leitchfield, KY. Organization (NPI-2).
NPI number1790740652
StatusActive
Last updated in NPPESAug 15, 2024
Details
- NPI
- 1790740652
- Entity type
- Organization (NPI-2)
- Legal business name
- Renal Life Link INC
- Organization subpart
- No
- Enumeration date
- Apr 20, 2006
- Certification date
- Aug 15, 2024
- Last updated
- Aug 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | 300171 | KY | Yes |
Other names
- Leitchfield Dialysis (Doing Business As)
Practice location
912 Wallace AveSte 106
Leitchfield, KY 42754-2405
Phone 270-230-0163 · Fax 270-230-0173
Mailing address
5200 Virginia WayAtt: L&C Dept
Brentwood, TN 37027-7569
Authorized official
Samuel T Wey
Vp Licensure & Certification
6153416641
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