Organization
SPRAGUE DIALYSIS LLC
Active
Other names
Mays Landing 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
4403 E BLACK HORSE PIKE, STE LL04, MAYS LANDING, NJ 08330-3103
(609) 813-2050
(609) 813-2055
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
—
0715514
—
NJ
Enumeration date
02/07/2019
Last updated
02/24/2025
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