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Organization

WOODMERE DIALYSIS,LLC

Active
Other names
Bay Bark Dalysis Center
Organization subpart
No

Provider details

NPI number
Authorized official
MILES DAVIS (DIRECTOR)
(800) 975-5201
Entity
Organization

Contact information

Practice address
801 CO OP CITY BLVD, BRONX, NY 10475-1603
(718) 239-6444
Mailing address
801 CO OP CITY BLVD, BRONX, NY 10475-1603
(718) 239-6444

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
01
2950210R
OPERATING CERTIFICATE
NY
Enumeration date
10/23/2019
Last updated
10/23/2019
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