Organization
MILLTOWN DIALYSIS LLC
Active
Other names
Platte Valley 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
1321 S 4TH AVE STE 100, BRIGHTON, CO 80601-6809
(303) 654-8202
(303) 654-8506
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
12H565
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174074223
—
CO
Enumeration date
10/24/2016
Last updated
04/24/2024
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