| NPI | 1962418756 |
|---|---|
| Doing Business As | LOUISA-FORT GAY REGIONAL DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | SUBHASH KUMAR Member 304-522-0274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |