Organization Name: | WHEELING RENAL CARE LLC |
NPI Number: | 1285630590 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBRA LUCKI (ASSISTANT ADMINISTRATOR) |
Mailing Address: | 68639 Bannock Rd Saint Clairsville |
State: | OH US |
Postal Code: | 439509736 |
Phone Number: | 7406990220 |
Fax Number: | 7406990703 |
NPI Enumeration Date: | 06/22/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | 0579DC |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |