Organization
ETOWAH DIALYSIS LLC
Active
Other names
St Lukes Bethlehem Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1425 8TH AVE, BETHLEHEM, PA 18018-2256
(484) 403-4304
(610) 866-1739
Mailing address
5200 VIRGINIA WAY, L & C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6410
(888) 662-8259
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
—
1029243170002
—
PA
Enumeration date
09/18/2013
Last updated
11/10/2023
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