Organization
FIVE STAR DIALYSIS LLC
Active
Other names
Five Star Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2400 TECH CENTER CT, LAS VEGAS, NV 89128-0804
(702) 869-3771
(702) 869-6366
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
—
1598934226
—
NV
Enumeration date
02/27/2008
Last updated
07/02/2025
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