Organization
RENVIVA DIALYSIS CENTER OF EASTERN PANHANDLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AKINYINKA AWOSIKA (MEMBER MANAGER)
(321) 710-0352
Entity
Organization
Contact information
Practice address
91 SUGAR HOLLOW RD STE E, BERKELEY SPRINGS, WV 25411-7243
(304) 944-7004
Mailing address
91 SUGAR HOLLOW RD STE E, BERKELEY SPRINGS, WV 25411-7243
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
08/29/2023
Last updated
05/28/2024
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