Organization
FORT DIALYSIS LLC
Active
Other names
Massillon Community 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
2112 LINCOLN WAY E, MASSILLON, OH 44646-7034
(330) 837-7730
(330) 837-7753
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
1034DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0082955
—
OH
Enumeration date
04/05/2012
Last updated
09/15/2025
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