Organization
COBBLES DIALYSIS LLC
Active
Other names
Channel Islands 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
3541 W 5TH ST STE A, OXNARD, CA 93030-6403
(805) 984-5140
(805) 984-5647
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
550002656
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346674157
—
CA
Enumeration date
08/28/2013
Last updated
05/08/2024
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