Organization
STINES DIALYSIS LLC
Active
Other names
Tidewater Home Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
230 CLEARFIELD AVE, STE 106, VIRGINIA BEACH, VA 23462-1832
(757) 518-9439
(757) 519-9519
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
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609110758
—
VA
Enumeration date
11/15/2012
Last updated
11/19/2025
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