Organization · Type 2 NPI

Conecuh Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Laurel, MD

NPI number 1235667130 Active

Practice location

14500 Laurel Pl
Laurel, MD 20707-4961

Call (301) 497-5454 Map

Fax (301) 776-2531

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: 1235667130
Entity type: Organization (Type 2)
Issued: May 23, 2017
Last updated: Apr 2, 2025
Status: Active

Other names

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Laurel Lakes Dialysis · doing business as
Laurel Lakes 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 1235667130

Conecuh Dialysis LLC's National Provider Identifier is 1235667130, issued on May 23, 2017. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Laurel, MD. The record was last updated on Apr 2, 2025.