Organization
PINE DIALYSIS LLC
Active
Other names
Westwego 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
1 WESTBANK EXPRESSWAY, WESTWEGO, LA 70094-4156
(504) 347-6942
(504) 347-6957
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, 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
—
2373757
—
LA
Enumeration date
10/19/2012
Last updated
10/07/2024
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