Organization · Type 2 NPI

Bridges Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Fort Wayne, IN

NPI number 1003119876 Active

Practice location

302 E Pettit Ave
Fort Wayne, IN 46806-3007

Call (260) 456-0451 Map

Fax (260) 458-9269

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1003119876
Entity type: Organization (Type 2)
Issued: Dec 16, 2010
Last updated: Aug 25, 2026
Status: Active

Other names

<unavail>
Fort Wayne South Dialysis · doing business as
Fort Wayne South Dialysis · doing business as

Authorized official

Samuel T Wey
VP, Licensure & Certification
(615) 341-6641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003119876

Bridges Dialysis LLC's National Provider Identifier is 1003119876, issued on Dec 16, 2010. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Fort Wayne, IN. The record was last updated on Aug 25, 2026.