KIDNEY LIFE LLC NPI 1427082361

NPI Information

NPI: 1427082361
Provider Name: KIDNEY LIFE, LLC
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
:
CLIA Number: 31D1004777
Address: 500 STATE ROUTE 35 S
RED BANK, NJ
ZIP 07701
Phone: (732) 576-9900

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NPI Details

KIDNEY LIFE, LLC is an end-stage renal disease (esrd) treatment clinic center in Red Bank, NJ. KIDNEY LIFE, LLC NPI is 1427082361. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

500 STATE ROUTE 35 S
RED BANK, NJ
ZIP 07701-038
Phone: (732) 576-9900
Fax: (732) 576-9908

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp, Licensure & Certification and has the following contact phone number (615) 341-6691.

The CLIA number assigned to this NPI record is 31D1004777 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 3/12/2025.

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	23175	NEW JERSEY	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	Other Provider Identifier Issuer
1	0971871	MEDICAID	NEW JERSEY

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: 11/21/2025

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