Healthcare Provider Details
I. General information
NPI: 1245483817
Provider Name (Legal Business Name): AMELIA PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1487 N HIGH ST UNIT 1A, NORTH HIGH BUSINESS CETER
HILLSBORO OH
45133-8496
US
IV. Provider business mailing address
749 SHIVEL LN
HUNTINGTON WV
25705-3842
US
V. Phone/Fax
- Phone: 937-393-9010
- Fax:
- Phone: 304-529-2090
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUBHASH
KUMAR
Title or Position: MEMBER
Credential: M.D.
Phone: 304-529-2090