Organization
WYANDOTTE CENTRAL DIALYSIS LLC
Active
Other names
Wyandotte Central Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3737 STATE AVE, KANSAS CITY, KS 66102-3830
(913) 233-0536
(913) 233-0903
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
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
—
200565880A
—
KS
Enumeration date
09/29/2006
Last updated
01/02/2024
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