Organization
GRAYSON DIALYSIS AND KIDNEY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBHASH KUMAR MD (OWNER MEDICAL DIRECTOR)
(304) 654-8074
Entity
Organization
Contact information
Practice address
1656 13TH AVE, HUNTINGTON, WV 25701-3829
(304) 529-2090
(304) 522-2658
Mailing address
286 HIGHWAY 1947, GRAYSON, KY 41143
(606) 474-2310
(606) 474-0569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000494978
ANTHEM BCBS PROV NUMBER
KY
05
—
3810006539
—
WV
Enumeration date
04/04/2007
Last updated
08/22/2020
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