Organization
BASTROP DIALYSIS LLC
Active
Other names
Upper Valley Kidney Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3190 N COUNTY ROAD 25A, TROY, OH 45373-1337
(937) 332-3733
(937) 332-3794
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
—
0088867
—
OH
Enumeration date
11/18/2012
Last updated
12/17/2025
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