Organization
BROOK DIALYSIS LLC
Active
Other names
Brandywine 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
7651 MATAPEAKE BUSINESS DR, SUITE 206, BRANDYWINE, MD 20613-3038
(301) 782-7863
(301) 782-3731
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
E2698
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4242921 00
—
MD
01
—
E2698
STATE LICENSE
MD
Enumeration date
12/03/2014
Last updated
12/31/2025
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