Organization
BLUEGRASS DIALYSIS LLC
Active
Other names
Williamstown 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
103 BARNES RD, STE A, WILLIAMSTOWN, KY 41097-9468
(859) 823-0500
(859) 823-0588
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
300202
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100061350
—
KY
Enumeration date
04/11/2008
Last updated
10/15/2024
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