Organization · Type 2 NPI

Cleburne Dialysis LLC

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

NPI number 1942554407 Active

Practice location

4797 Marlboro Pike
Capitol Heights, MD 20743-5213

Call (301) 420-1513 Map

Fax (301) 420-3912

Mailing address

5200 Virginia Way, L&c Department
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	E2683 (MD)

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

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NPI record

NPI: 1942554407
Entity type: Organization (Type 2)
Issued: Nov 6, 2012
Last updated: Oct 31, 2023
Status: Active

Other names

<unavail>
Coral Hills Dialysis · doing business as
Coral Hills Dialysis · doing business as

Authorized official

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

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About NPI 1942554407

Cleburne Dialysis LLC's National Provider Identifier is 1942554407, issued on Nov 6, 2012. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Capitol Heights, MD. The record was last updated on Oct 31, 2023.