Organization
KIDNEY LIFE, LLC
Active
Other names
West Orange Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
375 MOUNT PLEASANT AVE, STE 340, WEST ORANGE, NJ 07052-2750
(973) 243-7069
(973) 731-1348
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0968676
—
NJ
Enumeration date
12/07/2012
Last updated
03/11/2025
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