Organization
NEW BAY DIALYSIS LLC
Active
Other names
Corydon Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1937 OLD HIGHWAY 135 NW, CORYDON, IN 47112-2013
(812) 738-5200
(812) 738-4935
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200970240A
—
IN
05
—
7100130270
—
KY
01
—
=========
TRICARE
—
Enumeration date
03/12/2009
Last updated
06/28/2024
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