Organization
BUTANO DIALYSIS LLC
Active
Other names
Sequoia 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
440 N 11TH AVE, HANFORD, CA 93230-4404
(559) 587-0105
(559) 587-0293
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
550002246
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598026908
—
CA
Enumeration date
06/01/2012
Last updated
05/08/2024
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