MEDICARE: NORVIN DIALYSIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1578295895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORVIN DIALYSIS LLC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	ATTN L&C DEPT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:	615-341-6282
Fax Number	:	866-510-6389

Provider Business Practice Location Address
First Line	:	16410 SMOKEY POINT BVLD
Second Line	:	STE 205
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8414
Country	:	US
Telephone Number	:	615-341-6282
Fax Number	:	866-510-6389

Authorized Official
Title or Position	:	SR. DIRECTOR, LICENSURE & CERTIFICA
Name	:	SAM T WEY
Credential	:
Telephone Number	:	615-341-6691

Provider Enumeration Date	:	06/27/2022
Last Update Date	:	09/21/2023

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