Organization
ETOWAH DIALYSIS LLC
Active
Other names
St. Luke's Macungie Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2550 ROUTE 100, STE 2, MACUNGIE, PA 18062-9600
(610) 336-8350
(610) 336-8354
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029243170008
—
PA
Enumeration date
03/18/2019
Last updated
07/16/2025
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