Organization · Type 2 NPI

Isd Renal Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Jackson, MS

NPI number 1104871573 Active

Practice location

1828 Raymond Rd
Jackson, MS 39204-4126

Call (601) 373-7897 Map

Fax (601) 373-7899

Mailing address

5200 Virginia Way, L & C Department
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

3 other providers at this address

Other end-stage renal disease (esrd) treatment clinic/center providers in Jackson

See all in Jackson →

NPI record

NPI: 1104871573
Entity type: Organization (Type 2)
Issued: May 24, 2006
Last updated: Nov 19, 2024
Status: Active

Other names

<unavail>
Jackson Southwest Dialysis · doing business as
Jackson Southwest Dialysis · doing business as

Authorized official

Samuel T Wey
VP, Licensure & Certification
(615) 341-6641

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1104871573

Isd Renal Inc's National Provider Identifier is 1104871573, issued on May 24, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Jackson, MS. The record was last updated on Nov 19, 2024.