Organization
WADDELL DIALYSIS LLC
Active
Other names
Redhawk 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
44605 AVENIDA DE MISSIONES STE 100, TEMECULA, CA 92592-5001
(951) 302-3675
(951) 303-0716
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861949331
—
CA
Enumeration date
09/01/2016
Last updated
03/30/2026
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