Organization
TASKETT DIALYSIS LLC
Active
Other names
Philips Highway Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
8021 PHILIPS HWY, STE 15, JACKSONVILLE, FL 32256-7460
(904) 636-9652
(904) 636-9657
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105053100
—
FL
Enumeration date
01/31/2019
Last updated
08/27/2025
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