Smithgall Dialysis LLC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Chilton, WI. Organization (NPI-2).
NPI number1114320660
StatusActive
Last updated in NPPESJul 17, 2025
Details
- NPI
- 1114320660
- Entity type
- Organization (NPI-2)
- Legal business name
- Smithgall Dialysis LLC
- Organization subpart
- No
- Enumeration date
- Sep 29, 2014
- Certification date
- Jul 17, 2025
- Last updated
- Jul 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | – | – | Yes |
Other names
- Chilton Dialysis (Doing Business As)
Practice location
425 Mb LaneChilton, WI 53014-1604
Phone 920-849-3390 · Fax 920-849-3432
Mailing address
5200 Virginia WayL&C Dept
Brentwood, TN 37027-7569
Authorized official
Samuel T Wey
Vp, Licensure & Certification
6153416641
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