Organization
TRUE NORTH III DC LLC
Active
Other names
Grand Boulevard Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (ASSISTANT SECRETARY)
(615) 320-4414
Entity
Organization
Contact information
Practice address
860 GRAND BLVD, DEER PARK, NY 11729-5706
(631) 243-7770
(631) 243-7775
Mailing address
5200 VIRGINIA WAY, L AND C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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