Organization · Type 2 NPI

Lincolnton Dialysis LLC

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

NPI number 1659708139 Active

Practice location

10994 Baltimore St NE
Blaine, MN 55449-4601

Call (763) 786-5026 Map

Fax (763) 786-4138

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: 1659708139
Entity type: Organization (Type 2)
Issued: Sep 30, 2013
Last updated: Feb 4, 2025
Status: Active

Other names

<unavail>
Central Avenue Dialysis · doing business as
Central Avenue Dialysis · doing business as

Authorized official

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

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About NPI 1659708139

Lincolnton Dialysis LLC's National Provider Identifier is 1659708139, issued on Sep 30, 2013. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Blaine, MN. The record was last updated on Feb 4, 2025.