Organization
SUNACK DIALYSIS, LLC
Active
Other names
Moultrie Home Training
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
22 S MAIN ST, MOULTRIE, GA 31768-4573
(229) 785-1263
(229) 785-1284
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/22/2021
Last updated
07/14/2025
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