Organization
MARYSVILLE DIALYSIS CENTER LLC
Active
Other names
Marysville Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY AO (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1015 8TH ST, MARYSVILLE, CA 95901-5271
(530) 741-9801
(530) 741-9805
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3085
(800) 268-9682
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
110000524
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487617817
—
CA
Enumeration date
04/07/2006
Last updated
11/27/2023
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