Organization
KIDNEY LIFE, LLC
Active
Other names
Jersey City Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1310 5TH ST, NORTH BERGEN, NJ 07047-1710
(201) 770-9220
(201) 770-9225
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
22532
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0983519
—
NJ
Enumeration date
05/14/2012
Last updated
03/06/2026
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