Organization
MAGNOLIA DIALYSIS LLC
Active
Other names
Manasota 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
6960 PROFESSIONAL PKWY E, UNITS 4 & 5, SARASOTA, FL 34240-8428
(941) 362-2864
(941) 907-4720
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
—
014861600
—
FL
Enumeration date
09/02/2014
Last updated
11/18/2024
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