Organization
BLAKE DIALYSIS LLC
Active
Other names
Capitol Court 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
4176 N 56TH ST, MILWAUKEE, WI 53216-1276
(414) 445-2119
(414) 445-3794
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
Enumeration date
04/10/2013
Last updated
03/16/2026
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