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NPI 1073248563

NPI 1073248563 : GABION DIALYSIS LLC : SPOTSWOOD, NJ

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General NPI Number Information
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    NPI Number           |    1073248563
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    Entity Type          |    Organization 
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    Legal Business Name  |    GABION DIALYSIS LLC 
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Dates
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    Enumeration Date     |    07/19/2022
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    Last Update Date     |    06/17/2025
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Provider Practice Location Address
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    Address Line         |    404 MAIN ST STE E
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    City                 |    SPOTSWOOD
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    State                |    NJ
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    Zip                  |    08884-1795
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    Country              |    US
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    Telephone            |    848-289-0461
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    Fax                  |    848-289-0481
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Provider Business Mailing Address
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    Address Line         |    5200 VIRGINIA WAY L&C DEPT
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    City                 |    BRENTWOOD
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    State                |    TN
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    Zip                  |    37027-7569
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    VP LICENSURE & CERTIFICATION
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    Name                 |     SAMUEL  WEY 
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    Credential           |    
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    Telephone            |    615-341-6641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QE0700X
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    Taxonomy Name        |    End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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    License Number       |    
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    License Number State |    
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