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Organization
CLINCH VALLEY NEPHROLOGY INC
Active
Organization
CLINCH VALLEY NEPHROLOGY INC
Active
Other names
Richlands Express Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IN YOUNG PARK MD (CEO)
(276) 964-4001
Entity
Organization
Contact information
Practice address
2951 W FRONT STREET, CVMP SUITE B800, RICHLANDS, VA 24641
(276) 964-4001
(276) 964-4003
Mailing address
2951 W FRONT STREET, CVMP SUITE 1600, RICHLANDS, VA 24641
(276) 964-4001
(276) 964-4003
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
442324
ANTHEM
VA
Enumeration date
01/17/2007
Last updated
08/22/2020
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