Organization
LOURDES DIALYSIS LLC
Active
Other names
Clermont 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
1350 N HANCOCK RD, CLERMONT, FL 34711-5952
(352) 394-0072
(352) 241-0433
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
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102839700
—
FL
Enumeration date
08/07/2018
Last updated
02/03/2026
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