Healthcare Provider Details

I. General information

NPI: 1720826480
Provider Name (Legal Business Name): CAHITA DIALYSIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 HAYS LN STE 150
WILMINGTON NC
28411-3104
US

IV. Provider business mailing address

5200 VIRGINIA WAY L & C DEPARTMENT
BRENTWOOD TN
37027-5117
US

V. Phone/Fax

Practice location:
  • Phone: 615-341-5875
  • Fax:
Mailing address:
  • Phone: 615-341-5875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL WEY
Title or Position: VP, LICENSURE & CERTIFICATION
Credential:
Phone: 800-467-4736