Healthcare Provider Details

I. General information

NPI: 1891910865
Provider Name (Legal Business Name): KUMAR DIALYSIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 HIGHWAY 2565
LOUISA KY
41230-9166
US

IV. Provider business mailing address

1656 13TH AVE
HUNTINGTON WV
25701-3829
US

V. Phone/Fax

Practice location:
  • Phone: 606-638-3403
  • Fax: 606-638-3404
Mailing address:
  • Phone: 304-529-2062
  • Fax: 304-522-2658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SUBHASH KUMAR
Title or Position: OWNER MEDICAL DIRECTOR
Credential: M.D.
Phone: 304-654-8074