Organization
STALLINGTON DIALYSIS LLC
Active
Parent organization
DAVITA INC
Other names
Wilkes Barre Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVITA INC
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
950 E MOUNTAIN BLVD, WILKES BARRE, PA 18711-0028
(570) 899-6404
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, 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
—
1044852430002
—
PA
Enumeration date
02/09/2024
Last updated
10/07/2025
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