Organization
HOLTEN DIALYSIS LLC
Active
Other names
Serrano 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
1800 MEDICAL CENTER DR, STE 150, SAN BERNARDINO, CA 92411-1218
(909) 887-2717
(909) 887-3794
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3085
(800) 268-9682
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
—
1831560077
—
CA
Enumeration date
10/14/2015
Last updated
02/28/2024
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