SOMERVILLE DIALYSIS CENTER LLC NPI 1053599357

NPI Information

NPI: 1053599357
Provider Name: SOMERVILLE DIALYSIS CENTER LLC

Doing Business As: GALLERIA HOME TRAINING DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
9045 US HIGHWAY 64
STE 102
LAKELAND, TN
ZIP 38002
Phone: (901) 213-2955
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SOMERVILLE DIALYSIS CENTER LLC is an end-stage renal disease (esrd) treatment clinic center in Lakeland, TN. SOMERVILLE DIALYSIS CENTER LLC NPI is 1053599357. The provider is registered as an organization entity type.
The provider Is Doing Business As Galleria Home Training Dialysis.

The provider's business location address is:

9045 US HIGHWAY 64
STE 102
LAKELAND, TN
ZIP 38002-394
Phone: (901) 213-2955
Fax: (901) 213-1724

The provider's authorized official is Samuel T Wey .
The authorized official title is Sr Director Licensure&certification and has the following contact phone number (615) 341-6641.

The enumeration date for this NPI number is 2/8/2008 and was last updated on 8/17/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	08377719	MEDICAID	MISSISSIPPI
2	0442678	MEDICAID	TENNESSEE
3	177215134	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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