Organization
HUNTINGTON ARTIFICIAL KIDNEY CENTER LTD
Active
Other names
Medford Kidney Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (ASSISTANT SECRETARY)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1725 N OCEAN AVE, MEDFORD, NY 11763-2649
(631) 289-8000
(631) 289-8079
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
5153202R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03069707
—
NY
Enumeration date
06/30/2006
Last updated
12/04/2024
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