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Organization

KINGMAN KIDNEY CLINIC INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAMESH SARVA (ADMINISTRATOR)
(718) 268-6906
Entity
Organization

Contact information

Practice address
4055 STOCKTON HILL RD STE 15, KINGMAN, AZ 86409-2469
(928) 692-6500
Mailing address
10917 72ND RD STE 6R, FOREST HILLS, NY 11375-5336
(718) 268-6906

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
OTC2527
AZ

Other

Enumeration date
11/02/2006
Last updated
06/03/2014
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