Organization · Type 2 NPI

Lighthouse Dialysis LLC

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

NPI number 1639474265 Active

Practice location

1345 W Bush St
Lemoore, CA 93245-3303

Call (559) 924-3175 Map

Fax (559) 924-2485

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	550001590 (CA)

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

NPI record

NPI: 1639474265
Entity type: Organization (Type 2)
Issued: Jan 12, 2011
Last updated: Sep 11, 2023
Status: Active

Other names

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

Authorized official

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

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About NPI 1639474265

Lighthouse Dialysis LLC's National Provider Identifier is 1639474265, issued on Jan 12, 2011. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Lemoore, CA. The record was last updated on Sep 11, 2023.