Organization
VANCILE DIALYSIS LLC
Active
Other names
Duluth 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
3170 PEACHTREE INDUSTRIAL BLVD STE 100, DULUTH, GA 30097-8615
(770) 232-5219
(770) 476-3730
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003212349A
—
GA
Enumeration date
02/19/2018
Last updated
07/07/2025
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