Fort Campbell Dialysis

LBN: Ravalli Dialysis, Llc
Fort Campbell Dialysis is an health care organization with primary practice located at 1459 Fort Campbell Blvd , Clarksville TN 37042-3552. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Ravalli Dialysis, Llc can be contacted via phone (931) 552-6491, or through Wey, Samuel T via phone (615) 341-6641.

Contact Information

Primary practice address
1459 Fort Campbell Blvd Clarksville TN 37042-3552
Phone: (931) 552-6491
Fax: (931) 648-7946
Website:
Map and Directions
Authorized official contact:
Name: Wey, Samuel T
Phone: (615) 341-6641

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1588118897
LBN Legal business name Ravalli Dialysis, Llc
DBA Doing business as Fort Campbell Dialysis
Authorized official Wey, Samuel T
Entity Organization
Organization subpart 1 No
Enumeration date Aug 4th, 2016
Last updated Jul 17th, 2024 - about 4 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1588118897 NPPES
Tennessee Other 239 STATE LICENSE
Tennessee MEDICAID Q033487 STATE LICENSE

Popular Providers