Organization
GENTLE DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NABIL GUIRGUIS M.D. (MEMBER)
(304) 842-5668
Entity
Organization
Contact information
Practice address
166 THOMPSON DR, BRIDGEPORT, WV 26330-1644
(304) 842-5668
Mailing address
166 THOMPSON DR, BRIDGEPORT, WV 26330-1644
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
261QE0700X
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000048
—
WV
01
—
4124162
MEDICARE ID-TYPE UNSPECIFIED
WV
Enumeration date
11/17/2011
Last updated
11/17/2011
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