Organization · Type 2 NPI

Branbur Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Prince George, VA

NPI number 1043873664 Active

Practice location

4650 Puddledock Rd
Prince George, VA 23875-1235

Call (804) 957-5910 Map

Fax (804) 957-5916

Mailing address

5200 Virginia Way, L & C Department
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...

NPI record

NPI: 1043873664
Entity type: Organization (Type 2)
Issued: Apr 18, 2019
Last updated: Jan 26, 2026
Status: Active

Other names

<unavail>
Puddledock Dialysis · doing business as
Puddledock Dialysis · doing business as

Authorized official

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

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About NPI 1043873664

Branbur Dialysis LLC's National Provider Identifier is 1043873664, issued on Apr 18, 2019. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Prince George, VA. The record was last updated on Jan 26, 2026.