Organization
SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC
Active
Other names
Ocotillo 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
975 W CHANDLER HEIGHTS RD, UNIT 101, CHANDLER, AZ 85248-5724
(480) 802-4405
(480) 802-5390
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
—
506619
—
AZ
01
—
OTC4749
STATE LICENSE
AZ
Enumeration date
08/08/2009
Last updated
03/19/2026
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