Organization
BORREGO DIALYSIS LLC
Active
Other names
Western Ridge 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
6909 GOOD SAMARITAN DR, STE C, CINCINNATI, OH 45247-5209
(513) 353-0237
(513) 353-0230
Mailing address
5200 VIRGINIA WAY, ATT: 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
—
0203347
—
OH
Enumeration date
01/14/2016
Last updated
02/03/2025
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