MEDICARE: RENAL LIFE LINK INC

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	:	1326072638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAL LIFE LINK INC

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

Provider Business Practice Location Address
First Line	:	4102 N WATER TOWER PL
Second Line	:
City	:	MOUNT VERNON
State	:	IL
Zip	:	62864-6583
Country	:	US
Telephone Number	:	618-244-3407
Fax Number	:	618-242-6137

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	11/12/2025

Similar Medicare Providers

1043339476 — TENDER CARE PEDIATRIC DENTISTRY LLC
Practice Location Address:

6583 ROUTE 819 S , SUITE1
MOUNT PLEASANT, PA
15666-3503

Practice Phone: 724-542-4818
Practice Fax: 724-542-4828

1942429931 — BEATRIZ DE LA ROCHE D.M.D
Practice Location Address:

6583 ROUTE 819 S , SUITE 1
MOUNT PLEASANT, PA
15666-3503

Practice Phone: 724-542-4818
Practice Fax: 724-542-4828

1225903826 — AMY TOTH
Practice Location Address:

6583 ROUTE 819 S STE 2
MOUNT PLEASANT, PA
15666-2665

Practice Phone: 724-542-9702
Practice Fax: 724-542-9704

1063709731 — ERIN HOCKING AYERS O.D.
Practice Location Address:

2900 BROADWAY ST , SUITE A
MOUNT VERNON, IL
62864-2341

Practice Phone: 618-244-2777
Practice Fax: 618-997-6250

1093718900 — SSM HEALTH BUSINESSES
Practice Location Address:

1501 MCPHERSON AVE
MOUNT VERNON, IL
62864-2831

Practice Phone: 618-899-1624
Practice Fax: 615-899-4744

1548264237 — PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS
Practice Location Address:

8 CUSUMANO PROFESSIONAL PLAZA DR
MOUNT VERNON, IL
62864-6736

Practice Phone: 618-242-7819
Practice Fax:

Directions to “RENAL LIFE LINK INC ” 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.