NPI 1013433713

Havanna Dialysis LLC

Organisation End-Stage Renal Disease (ESRD) Treatment Clinic/Center Gaithersburg, MD

Practice location

Address: 202 Perry Pkwy STE 3, Gaithersburg, MD 20877-2172
Phone: (301) 987-0912
Fax: (301) 947-6115
Mailing address: 5200 Virginia Way L&c Department, Brentwood, TN 37027-7569

Authorised official

Name: Samuel T Wey
Title: Vp Licensure & Certification
Phone: (615) 341-6641

Registered specialties

End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QE0700X

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Registry record

NPI: 1013433713
Entity type: Organization
NPI issued: 15 Aug 2017
Record last updated: 17 Nov 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.