Organization
KIDNEY LIFE, LLC
Active
Organization
KIDNEY LIFE, LLC
Active
Other names
Holmdel Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 320-4414
Entity
Organization
Contact information
Practice address
3053 STATE ROUTE 35, HAZLET, NJ 07730-1526
(732) 203-0321
(732) 203-0279
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6410
(888) 662-8259
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
41302
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0983411
—
NJ
Enumeration date
07/03/2006
Last updated
03/11/2025
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