# LANER DIALYSIS SUPPLY CO., LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679568786
- **Authorized official:** MRS. FELICITAS C. ESPIRITU (MEMBER)
- **Authorized official phone:** (304) 720-5050

## Contact information

- **Practice address:** 153 CHURCH CAMP RD, HURRICANE, WV 25526-9261
- **Practice address phone:** (304) 720-5050
- **Practice address fax:** (304) 720-5050
- **Mailing address:** 24 MACCORKLE AVE SW, SUITE 200, SOUTH CHARLESTON, WV 25303-1476
- **Mailing address phone:** (304) 720-5050
- **Mailing address fax:** (304) 720-5050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BD1200X | Dialysis Equipment & Supplies (DME) | 0353710-001 | WV | Yes |

## Other

- **Enumeration date:** 09/14/2005
- **Last updated:** 08/22/2020