Organization
STAR DIALYSIS LLC
Active
Other names
Siskiyou 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
50 ROSSANLEY DR, MEDFORD, OR 97501
(541) 414-2437
(541) 414-2438
Mailing address
5200 VIRGINIA WAY, 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
Enumeration date
03/28/2019
Last updated
08/12/2024
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