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Organization

KINGSTON DIALYSIS LLC

Active
Other names
Thornton Dialysis Center
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
8800 FOX DR, THORNTON, CO 80260
(303) 430-7020
(303) 487-9572
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
120406
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120406
STATE LICENSE
CO
05
1386012268
CO
Enumeration date
09/09/2015
Last updated
12/05/2024
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