CLAYMOUNT DIALYSIS LLC NPI 1699323824

NPI Information

NPI: 1699323824
Provider Name: CLAYMOUNT DIALYSIS LLC
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
Doing Business As: UPPER DEERFIELD DIALYSIS
CLIA Number: 31D2181381
Address: 21 CORNWELL DR
BRIDGETON, NJ
ZIP 08302
Phone: (856) 453-2380

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NPI Details

CLAYMOUNT DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Bridgeton, NJ. CLAYMOUNT DIALYSIS LLC NPI is 1699323824. The provider is registered as an organization entity type.
The provider Is Doing Business As Upper Deerfield Dialysis.

The provider's business location address is:

21 CORNWELL DR
BRIDGETON, NJ
ZIP 08302-632
Phone: (856) 453-2380
Fax: (856) 453-2385

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) 341-6641.

The CLIA number assigned to this NPI record is 31D2181381 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2019 and was last updated on 11/21/2024.

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	Other Provider Identifier Issuer
1	0731676	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: 3/30/2025

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