Organization
KIMBALL DIALYSIS LLC
Active
Other names
Montage Home Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3358 BIRNEY PLZ, MOOSIC, PA 18507-1560
(570) 344-1745
(570) 344-1097
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
—
102772930 0002
—
PA
Enumeration date
04/24/2013
Last updated
06/24/2025
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