Organization
POINSETT DIALYSIS LLC
Active
Other names
Windsor Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2707 N ROLLING RD, SUITE 104-105, WINDSOR MILL, MD 21244-2157
(410) 944-2649
(410) 944-2726
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2632
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4233794 00
—
MD
01
—
E2632
STATE LICENSE
MD
Enumeration date
09/16/2014
Last updated
10/08/2024
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