Etowah Dialysis LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Allentown, PA
NPI 1376909515 · NPPES record last updated Nov 13, 2025
Key facts
- NPI
- 1376909515
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- ETOWAH DIALYSIS LLC
- Practice address
- 1901 Hamilton St
Ste 200
Allentown, PA 18104-6460 - Phone
- (610) 776-1479
- Fax
- (610) 433-6306
- NPI assigned
- Jan 4, 2016
- Organization subpart
- No
Authorized official
- Name
- Samuel Wey
- Title
- VP, Licensure & Certification
- Phone
- (615) 341-6641
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 6
Member of 1
Affiliated clinicians 4
-
Ravi Agrawal, M.B.B.S
-
Adam D Dratch, MD
-
Sana Rab Akbar, M.D.
Medicare Care Compare: Dialysis facility
- Listed as
- DaVita St Luke's at Home
- Ownership
- Profit
- Certified
- Mar 3, 2016
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160203001227 | PA | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 2567699085 | Practice locations: Allentown, PA |
National Provider Directory
- Tax ID family
- Etowah Dialysis LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
1901 Hamilton St
Ste 200
Allentown, PA 18104-6460
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1029243170005 | Medicaid | PA |
Other names
- St Lukes Home Training
Other providers in Allentown, PA
- Estern Valley Pharmacy Inc
- Carlos Estevez
- Walka Estevez
- Marifel Estrada-Currie
- Cromwell C Estrada
- Etowah Dialysis LLC
- Eugene J McGuire DDS, PC
- Kelsey Rose Evan
- Rebekah Evangelista
- Chelsea Marshall Evans
All providers in Allentown, PA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.