| NPI | 1912136771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN M MCDANIEL Provider Relations Supervisor 304-293-5033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2009-07-14 |