Organization
DAVITA OF GREENBRIER
Active
Other names
Gambro Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN KELLEY RN (FACILITY ADMINISTRATOR)
(304) 645-4806
Entity
Organization
Contact information
Practice address
129 SENECA TRL, LEWISBURG, WV 24901-1564
(304) 645-4806
(304) 647-3941
Mailing address
129 SENECA TRL, LEWISBURG, WV 24901-1564
(304) 645-4806
(304) 647-3941
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
030330
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005742000
—
WV
Enumeration date
09/11/2007
Last updated
09/11/2007
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