Organization
CHALLIS DIALYSIS LLC
Active
Other names
Brookside 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
10725 WILES RD, CORAL SPRINGS, FL 33076-2014
(954) 796-9925
(954) 796-7360
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101433300
—
FL
Enumeration date
11/03/2017
Last updated
10/24/2023
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