Organization
WHEELING RENAL CARE LLC
Active
Other names
Belmont Dialysis @ Crestview
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA LUCKI R.N. (ASSISTANT ADMINISTRATOR)
(304) 242-7770
Entity
Organization
Contact information
Practice address
68639 BANNOCK RD, SAINT CLAIRSVILLE, OH 43950-9736
(740) 699-0220
(740) 699-0703
Mailing address
500 MEDICAL PARK, STE 100, WHEELING, WV 26003-7600
(304) 242-7770
(304) 243-3216
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0579DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0401005000
—
WV
05
—
0459374
—
OH
Enumeration date
06/22/2005
Last updated
08/22/2020
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