Organization
BAINBRIDGE DIALYSIS LLC
Active
Other names
Central Fort Worth 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
1000 SAINT LOUIS AVE STE 101, FORT WORTH, TX 76104-3377
(817) 810-0379
(817) 870-9767
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
—
3397549-01
—
TX
Enumeration date
03/29/2012
Last updated
02/20/2026
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