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Organization

SWANVILLE DIALYSIS, LLC

Active
Other names
Eagles Nest Home Training
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
105 ADAIR DR STE B, GOLDSBORO, NC 27530-4516
(615) 341-5875
Mailing address
5200 VIRGINIA WAY, LICENSURE & CERTIFICATION, BRENTWOOD, TN 37027-7569
(615) 341-5875

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary

Other

Enumeration date
09/22/2023
Last updated
02/08/2024
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