OrganizationActive
Wakonda Dialysis LLC
NPI 1992223556 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Salem, UT
Provider details
- NPI number
- 1992223556
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Samuel Wey, Vp, Licensure & Certification(615) 341-6641
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
555 W State Road 164 Ste 101
Salem, UT 84653-5732
Phone: (801) 798-7903
Fax: (801) 798-7237
Approximate (ZIP-level) locationGet directions
Mailing address
5200 Virginia Way
Brentwood, TN 37027-7569
Other names (DBA / former)
- Doing business as
- Mt Nebo Dialysis
- Doing business as
- Mt Nebo Dialysis
Registry dates
- Enumerated
- 2017-09-05
- Last updated
- 2024-10-28
- Certified
- 2024-10-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.