Organization
ENCHANTED DIALYSIS LLC
Active
Other names
Newark Wayne Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
1120 S MAIN ST, NEWARK, NY 14513-2171
(315) 331-6958
(315) 331-6521
Mailing address
5200 VIRGINIA WAY, L & C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6410
(888) 662-8259
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
—
03871836
—
NY
Enumeration date
07/22/2013
Last updated
10/08/2020
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