Organization
CHERAW DIALYSIS LLC
Active
Other names
El Sobrante 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
3380 SAN PABLO DAM RD STE C-D, SAN PABLO, CA 94803-7218
(510) 262-9230
(510) 262-9203
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
—
112443791
—
CA
01
—
550003151
LICENSE
CA
Enumeration date
02/19/2014
Last updated
10/07/2024
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