Organization
LORY DIALYSIS LLC
Active
Other names
Premiere Kidney Center of Newark
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
65 S TERRACE AVE, NEWARK, OH 43055-1355
(740) 522-2955
(740) 522-2975
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3051
(800) 246-8346
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
—
0057201
—
OH
Enumeration date
07/18/2011
Last updated
12/21/2023
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