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Organization

LURLEEN DIALYSIS LLC

Active
Other names
Jeffersonville 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
365 QUARTERMASTER CT, JEFFERSONVILLE, IN 47130-3670
(812) 288-2296
(812) 288-4153
Mailing address
5200 VIRGINIA WAY, ATT: 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
201074330A
IN
Enumeration date
01/04/2011
Last updated
08/02/2024
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