Organization
PRENCOE DIALYSIS, LLC
Active
Other names
Licking River Home Training
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(615) 341-5875
Entity
Organization
Contact information
Practice address
140 PLAZA DR, COLD SPRING, KY 41076-2166
(859) 993-0244
(859) 993-0259
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 341-5875
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
08/17/2021
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