Organization
SPRAGUE DIALYSIS LLC
Active
Other names
Millville Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
3 ELIZABETH ST, MILLVILLE, NJ 08332-2509
(856) 327-4580
(856) 327-4584
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
24338
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0590118
—
NJ
Enumeration date
12/09/2016
Last updated
03/09/2021
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