NPI Code Details Logo

NPI 1053659474

NPI 1053659474 : RYE DIALYSIS, LLC : PEARISBURG, VA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1053659474
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    RYE DIALYSIS, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/18/2013
-----------------------------------------------------
    Last Update Date     |    12/13/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    377 BOXWOOD LN 
-----------------------------------------------------
    City                 |    PEARISBURG
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    24134-1166
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    540-921-1384
-----------------------------------------------------
    Fax                  |    540-921-1864
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    5200 VIRGINIA WAY L&C DEPT
-----------------------------------------------------
    City                 |    BRENTWOOD
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37027-7569
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    VP LICENSURE & CERTIFICATION
-----------------------------------------------------
    Name                 |     SAMUEL  WEY 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    615-341-6641
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QE0700X
-----------------------------------------------------
    Taxonomy Name        |    End-Stage Renal Disease (ESRD) Treatment Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.