Organization
SMITHGALL DIALYSIS LLC
Active
Other names
Chilton 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
425 MB LANE, CHILTON, WI 53014-1604
(920) 849-3390
(920) 849-3432
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
—
1114320660
—
WI
Enumeration date
09/29/2014
Last updated
07/17/2025
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