Organization
ROUTT DIALYSIS LLC
Active
Other names
Sparks 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
777 VISTA BLVD, SPARKS, NV 89434-6656
(775) 356-3978
(775) 356-3971
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6814
(800) 293-8405
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
498ESR
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629218185
—
NV
Enumeration date
02/24/2009
Last updated
12/21/2023
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