Organization
CLARK DIALYSIS LLC
Active
Other names
Annapolis 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
1127 WEST ST, STE 100, ANNAPOLIS, MD 21401-3615
(410) 626-6139
(410) 268-1294
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
—
4228812 00
—
MD
Enumeration date
02/07/2013
Last updated
04/08/2026
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