Organization
STAR DIALYSIS LLC
Active
Other names
Grants Pass II 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
1055 REDWOOD AVE, GRANTS PASS, OR 97527-5525
(541) 479-0545
(541) 479-4271
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
17-0097
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500669206
—
OR
Enumeration date
06/15/2013
Last updated
09/30/2025
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