Organization
KIDNEY SERVICES OF WEST CENTRAL OHIO LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DORINDA J WEST RN (ADMINISTRATOR)
(419) 227-0918
Entity
Organization
Contact information
Practice address
601 U S STATE ROUTE 224, GLANDORF, OH 45848
(419) 226-4420
(419) 226-4440
Mailing address
601 ST ROUTE 224, PO BOX 100, GLANDORF, OH 45848
(419) 226-4420
(419) 226-4440
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0754DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2555668
—
OH
Enumeration date
07/07/2005
Last updated
04/04/2011
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