Organization
CLIFTON DIALYSIS LLC
Active
Other names
South Shore Annex 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
16750 HIGHWAY 3, WEBSTER, TX 77598-2000
(281) 332-4719
(281) 332-3720
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4224
(800) 293-4707
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
—
363566601
—
TX
Enumeration date
12/03/2013
Last updated
12/13/2023
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