NPI | 1255566444 |
---|---|
Doing Business As | 12TH STREET COVINGTON DIALYSIS |
Entity Type | Organization |
Authorized Contact | JOHN D WINSTEL Chief Accounting Officer 253-733-4501 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: KY 300215) |
Enumeration Date | 2009-05-18 |
Last Update Date | 2022-09-01 |