Organization
WISSOTA DIALYSIS LLC
Active
Other names
Chatham Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
13912 US HIGHWAY 29, CHATHAM, VA 24531-3669
(434) 432-1790
(434) 432-1785
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4214
(866) 944-3352
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
—
1235646845
—
VA
Enumeration date
01/04/2018
Last updated
12/11/2023
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