Organization
LEAWOOD DIALYSIS LLC
Active
Other names
Kidney Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
640 MARTIN LUTHER KING JR BLVD STE 100, MACON, GA 31201-3297
(478) 742-5850
(478) 742-5860
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
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
907820770A
—
GA
Enumeration date
11/03/2017
Last updated
10/17/2025
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