Organization
BRUNO DIALYSIS LLC
Active
Other names
Mainplace 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
146 S MAIN ST, ORANGE, CA 92868-2861
(714) 938-0870
(714) 937-2986
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3085
(800) 268-9682
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
080000681
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679718225
—
CA
Enumeration date
12/11/2008
Last updated
06/04/2024
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