Organization
SAFEHARBOR DIALYSIS LLC
Active
Other names
East Tampa 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
1701 E 9TH AVE, YBOR CITY, FL 33605-3801
(813) 247-1820
(813) 247-3129
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
—
001939400
—
FL
Enumeration date
12/04/2008
Last updated
07/16/2024
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