BRANBUR DIALYSIS LLC NPI 1043873664

NPI Information

  • NPI: 1043873664
  • Provider Name: BRANBUR DIALYSIS LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • :
  • CLIA Number: 49D2170164
  • Address: 4650 PUDDLEDOCK RD
    PRINCE GEORGE, VA
    ZIP 23875
  • Phone: (804) 957-5910

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NPI Details

BRANBUR DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Prince George, VA. BRANBUR DIALYSIS LLC NPI is 1043873664. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

4650 PUDDLEDOCK RD
PRINCE GEORGE, VA
ZIP 23875-235
Phone: (804) 957-5910
Fax: (804) 957-5916

The provider's authorized official is Samuel 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 49D2170164 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/18/2019 and was last updated on 4/11/2025.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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
11043873664MEDICAIDVIRGINIA

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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