Organization Name: | GREENBRIER VMC, LLC |
NPI Number: | 1447581434 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURIE HOLTSFORD (DIRECTOR) |
Mailing Address: | 202 Maplewood Ave Ronceverte |
State: | WV US |
Postal Code: | 249701334 |
Phone Number: | 3043474411 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2010 |
NPI Last Update Date: | 01/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | 55 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |