BULLOCK DIALYSIS LLC – NPI #1639715808
Clinic/Center

BULLOCK DIALYSIS LLC is an AHC clinic located in CINCINNATI, OH. NPPES has assigned the NPI number 1639715808 to BULLOCK DIALYSIS LLC on November 22, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was last updated on Sep 03, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BULLOCK DIALYSIS LLC below.

NPI Profile for
BULLOCK DIALYSIS LLC

NPI Number
1639715808
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BULLOCK DIALYSIS LLC
Primary location
2290 FERGUSON RD
CINCINNATI, OH 45238
Phone: (513) 347-3626 Fax: (513) 347-2680
Mailing address
5200 VIRGINIA WAY
ATT: L&C DEPT
BRENTWOOD, TN 37027-7569
Phone: Fax:
Organization Subpart
Yes - BULLOCK DIALYSIS LLC is subpart of another organization.
Authorized Official
SAMUEL WEY
VP LICENSURE & CERTIFICATION
Phone: (615) 341-6641
Updated
Certification Date
Sep 03, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.