Organization
KIDNEY LIFE, LLC
Active
Organization
KIDNEY LIFE, LLC
Active
Other names
Princeton Junction 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
88 PRINCETON HIGHTSTOWN RD, STE 102, PRINCETON JUNCTION, NJ 08550-1100
(609) 799-0084
(609) 275-7441
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
—
0982377
—
NJ
Enumeration date
08/19/2010
Last updated
03/12/2025
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