MEDICARE: PALMETTO DIALYSIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629336599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMETTO DIALYSIS LLC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L&C DEPT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:	615-341-6264
Fax Number	:	800-297-2925

Provider Business Practice Location Address
First Line	:	102 RICHARDSON XING
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-6023
Country	:	US
Telephone Number	:	636-467-5619
Fax Number	:	636-467-5997

Authorized Official
Title or Position	:	VP LICENSURE & CERTIFICATION
Name	:	SAMUEL T. WEY
Credential	:
Telephone Number	:	615-341-6641

Provider Enumeration Date	:	04/30/2012
Last Update Date	:	03/25/2024

Similar Medicare Providers

1922959121 — TAYLOR KATHLEEN WALLIS DPT
Practice Location Address:

118 RICHARDSON XING
ARNOLD, MO
63010-6023

Practice Phone: 636-206-4146
Practice Fax: 636-223-2542

1740279967 — DR. ERIN MARISCAL D.D.S.
Practice Location Address:

124 RICHARDSON XING
ARNOLD, MO
63010-6023

Practice Phone: 636-464-6444
Practice Fax: 636-464-6465

1114939865 — RACHEL STEINLAGE MPT
Practice Location Address:

118 RICHARDSON XING
ARNOLD, MO
63010-6023

Practice Phone: 636-206-4146
Practice Fax:

1710210604 — KOURTNEY HEITZ PT
Practice Location Address:

118 RICHARDSON XING
ARNOLD, MO
63010-6023

Practice Phone: 636-206-4146
Practice Fax:

1851689335 — TOTAL RENAL CARE INC
Practice Location Address:

102 RICHARDSON XING
ARNOLD, MO
63010-6023

Practice Phone: 636-467-5619
Practice Fax: 636-467-5997

1740530468 — TONYA N BECKER PT, DPT
Practice Location Address:

118 RICHARDSON XING
ARNOLD, MO
63010-6023

Practice Phone: 636-206-4146
Practice Fax: 636-223-2542

Directions to “PALMETTO DIALYSIS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.