Organization
ETOWAH DIALYSIS LLC
Active
Other names
St Lukes Home Training
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1901 HAMILTON ST, STE 200, ALLENTOWN, PA 18104-6460
(610) 776-1479
(610) 433-6306
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
—
1029243170005
—
PA
Enumeration date
01/04/2016
Last updated
11/13/2025
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