Organization
PHYSICIANS DIALYSIS ACQUISITIONS INC
Active
Other names
PDI Grand Rapids
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
801 CHERRY ST SE, GRAND RAPIDS, MI 49506-1440
(616) 458-5100
(616) 458-5200
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
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
—
4307258
—
MI
Enumeration date
04/01/2006
Last updated
09/25/2023
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