Organization
OWASSO DIALYSIS LLC
Active
Other names
Owasso 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
9521 N OWASSO EXPY, OWASSO, OK 74055-5414
(918) 376-9479
(918) 376-2781
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200489660A
—
OK
Enumeration date
03/17/2011
Last updated
09/04/2025
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