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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