Sprague Dialysis LLC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Bridgeton, NJ. Organization (NPI-2).
NPI number1639613649
StatusActive
Last updated in NPPESJun 15, 2026
Details
- NPI
- 1639613649
- Entity type
- Organization (NPI-2)
- Legal business name
- Sprague Dialysis LLC
- Organization subpart
- No
- Enumeration date
- Dec 9, 2016
- Certification date
- Jun 15, 2026
- Last updated
- Jun 15, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART A PROVIDER - END-STAGE RENAL DISEASE FACILITY (ESRD)
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | 25050 | NJ | Yes |
Other names
- Bridgeton Dialysis (Doing Business As)
Practice location
333 Irving AveBridgeton, NJ 08302-2123
Phone 856-575-4200 · Fax 856-453-0174
Mailing address
5200 Virginia WayL&C Dept
Brentwood, TN 37027-7569
Authorized official
Samuel Wey
Vp, Licensure & Certification
6153416641
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