Organization · Type 2 NPI

Ravine Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Wayne, WV

NPI number 1215389747 Active

Practice location

600 Mcginnis Dr
Wayne, WV 25570

Call (304) 272-3703 Map

Fax (304) 272-3476

Mailing address

5200 Virginia Way, L & C Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

NPI record

NPI: 1215389747
Entity type: Organization (Type 2)
Issued: Jul 8, 2016
Last updated: Aug 16, 2018
Status: Active

Other names

<unavail>
Beech Fork Dialysis · doing business as
Beech Fork Dialysis · doing business as

Authorized official

James K Hilger
Chief Accounting Officer
(253) 733-4500

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About NPI 1215389747

Ravine Dialysis LLC's National Provider Identifier is 1215389747, issued on Jul 8, 2016. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Wayne, WV. The record was last updated on Aug 16, 2018.