Organization · Type 2 NPI

Renal Treatment Centers-Illinois Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Columbia, MO

NPI number 1629039300 Active

Practice location

1701 E Broadway Ste G102
Columbia, MO 65201-8029

Call (573) 442-0573 Map

Fax (573) 442-3498

Mailing address

5200 Virginia Way, L&c Dept
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...

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NPI record

NPI: 1629039300
Entity type: Organization (Type 2)
Issued: Mar 31, 2006
Last updated: Jul 15, 2025
Status: Active

Other names

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RTC Columbia Dialysis · doing business as
RTC Columbia Dialysis · doing business as

Authorized official

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

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About NPI 1629039300

Renal Treatment Centers-Illinois Inc's National Provider Identifier is 1629039300, issued on Mar 31, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Columbia, MO. The record was last updated on Jul 15, 2025.