MEDICARE: CLEBURNE 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	E2683	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942554407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEBURNE DIALYSIS LLC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L&C DEPARTMENT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:	615-320-4214
Fax Number	:	866-944-3352

Provider Business Practice Location Address
First Line	:	4797 MARLBORO PIKE
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-5213
Country	:	US
Telephone Number	:	301-420-1513
Fax Number	:	301-420-3912

Authorized Official
Title or Position	:	VP LICENSURE & CERTIFICATION
Name	:	SAMUEL T WEY
Credential	:
Telephone Number	:	615-341-6641

Provider Enumeration Date	:	11/06/2012
Last Update Date	:	10/31/2023

Similar Medicare Providers

1881543221 — COMPASS HEALTH SERVICES LLC
Practice Location Address:

4725 MARLBORO PIKE
CAPITOL HEIGHTS, MD
20743-5213

Practice Phone: 301-329-5753
Practice Fax: 301-997-2192

1841149283 — COMPASS HEALTH SERVICES LLC
Practice Location Address:

4725 MARLBORO PIKE
CAPITOL HEIGHTS, MD
20743-5213

Practice Phone: 667-239-3144
Practice Fax: 667-239-3146

1023967361 — COMPASS HEALTH SERVICES LLC
Practice Location Address:

4725 MARLBORO PIKE
CAPITOL HEIGHTS, MD
20743-5213

Practice Phone: 443-683-6852
Practice Fax:

1477308575 — DIMENSIONS HEALTHCARE ASSOCIATES INC
Practice Location Address:

4725 MARLBORO PIKE
CAPITOL HEIGHTS, MD
20743-5213

Practice Phone: 240-719-2438
Practice Fax:

1407833270 — DR. BASIL JOHN MARRELLA DO
Practice Location Address:

30855 JOHN R RD
MADISON HEIGHTS, MI
48071-5213

Practice Phone: 248-583-0100
Practice Fax: 248-583-4894

1457167447 — MR. ROBERT D JONES
Practice Location Address:

5213 CATHERINE ST
MAPLE HEIGHTS, OH
44137-1405

Practice Phone: 216-270-9927
Practice Fax:

Directions to “CLEBURNE DIALYSIS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.