Organization · Type 2 NPI

Maple Grove Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Maple Grove, MN

NPI number 1255518247 Active

Practice location

15655 Grove Cir N
Maple Grove, MN 55369-4489

Call (763) 420-2804 Map

Fax (763) 420-7162

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...

Other end-stage renal disease (esrd) treatment clinic/center providers in Maple Grove

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NPI record

NPI: 1255518247
Entity type: Organization (Type 2)
Issued: Jan 22, 2008
Last updated: Apr 11, 2025
Status: Active

Other names

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Maple Grove Dialysis Unit · doing business as
Maple Grove Dialysis Unit · doing business as

Authorized official

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

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About NPI 1255518247

Maple Grove Dialysis LLC's National Provider Identifier is 1255518247, issued on Jan 22, 2008. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Maple Grove, MN. The record was last updated on Apr 11, 2025.