Organization
DIALYSIS SERVICES OF BELPRE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUBBARAYUDU KOPPERA M.D. (MEDICAL DIRECTOR)
(740) 401-0880
Entity
Organization
Contact information
Practice address
809 FARSON AVE, SUITE 108, BELPRE, OH 45714-1066
(740) 401-0880
(740) 401-0885
Mailing address
809 FARSON AVE, SUITE 108, BELPRE, OH 45714-1066
(740) 401-0880
(740) 401-0885
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0533051
—
OH
Enumeration date
01/11/2007
Last updated
04/30/2012
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