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Organization

CORVA CLINICS, LLC - GULF COAST

Active
Other names
Corva Gulf Coast Dialysis Center
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY SIMONSEN (CEO)
(720) 402-3881
Entity
Organization

Contact information

Practice address
10233 S PARKER RD, SUITE 300, PARKER, CO 80134-9314
(720) 402-3881
Mailing address
10233 S PARKER RD, SUITE 300, PARKER, CO 80134-9314
(720) 402-3881

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
05
007209200
FL
Enumeration date
10/18/2012
Last updated
07/26/2016
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