Organization
PRINEVILLE DIALYSIS LLC
Active
Other names
Pocono Home Training, Pocono Home Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3361 ROUTE 611, STE 1, BARTONSVILLE, PA 18321-7821
(570) 629-1292
(570) 629-2482
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
—
1028331050001
—
PA
Enumeration date
07/30/2012
Last updated
03/06/2026
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