Organization
DAVITA UPSTATE DIALYSIS
Active
Other names
Upstate Dialysis #382
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA J. GAYLE RN (FACILITY ADMINISTRATOR)
(864) 271-3700
Entity
Organization
Contact information
Practice address
308 MILLS AVENUE, GREENVILLE, SC 29605
(864) 271-3700
(864) 271-7929
Mailing address
308 MILLS AVENUE, GREENVILLE, SC 29605
(864) 271-3700
(864) 271-7929
Taxonomy
Speciality
Code
Description
License number
State
163WD1100X
Peritoneal Dialysis Registered Nurse
Primary
ERD-098
SC
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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