Organization · Type 2 NPI

Bohama Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Rancho Cucamonga, CA

NPI number 1497095905 Active

Practice location

8219 Rochester Ave, Ste 120
Rancho Cucamonga, CA 91730-0723

Call (909) 466-5489 Map

Fax (909) 477-2098

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: 1497095905
Entity type: Organization (Type 2)
Issued: Feb 20, 2013
Last updated: Mar 29, 2024
Status: Active

Other names

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Rancho Cucamonga Home Training · doing business as
Rancho Cucamonga Home Training · doing business as

Authorized official

Samuel 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 1497095905

Bohama Dialysis LLC's National Provider Identifier is 1497095905, issued on Feb 20, 2013. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Rancho Cucamonga, CA. The record was last updated on Mar 29, 2024.