Organization
WILLISTON DIALYSIS, LLC
Active
Other names
Oceana Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE AND CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1375 OCEANA BLVD, SUITE 114, VIRGINIA BEACH, VA 23454-5579
(757) 961-6239
(757) 961-6665
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4214
(866) 944-3352
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
—
1831544972
—
VA
Enumeration date
04/26/2016
Last updated
03/18/2024
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