Organization
AMERICAN FORK DIALYSIS LLC
Active
Other names
Lone Peak 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
1175 E 50 S STE 111, AMERICAN FORK, UT 84003-2846
(801) 763-1304
(801) 763-1305
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
—
1306025499
—
UT
Enumeration date
10/25/2007
Last updated
09/11/2025
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