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Organization

BLAKE DIALYSIS LLC

Active
Other names
Mill Street HomeTraining
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
N54 W6135 MILL ST, STE 500, CEDARBURG, WI 53012-2067
(262) 377-2158
(262) 377-2191
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 341-6264
(800) 297-2925

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary

Other

Enumeration date
07/27/2011
Last updated
02/23/2024
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