Organization
BRIDGES DIALYSIS LLC
Active
Other names
Summit City 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
3233 E COLISEUM BLVD, FORT WAYNE, IN 46805-1561
(260) 373-1599
(260) 373-1555
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
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
—
201128730A
—
IN
Enumeration date
02/27/2012
Last updated
12/20/2024
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