PONCA DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in San Jose, CA. PONCA DIALYSIS LLC NPI is 1538400239. The provider is registered as an organization entity type.
The provider Is Doing Business As Tully Road Home Training.
The provider's business location address is:
1290 TULLY RD
STE 60
SAN JOSE, CA
ZIP 95122-069
Phone: (408) 275-0105
Fax: (408) 275-0115
The provider's authorized official is Samuel Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.
The CLIA number assigned to this NPI record is 05D2063037 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/6/2013 and was last updated on 3/29/2024.