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General NPI Number Information
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NPI Number | 1215485883
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Entity Type | Organization
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Legal Business Name | BELMONT DIALYSIS LLC
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 09/24/2020
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Provider Practice Location Address
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Address Line | 3737 W MAIN ST STE 103
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City | SALEM
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State | VA
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Zip | 24153-2073
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Country | US
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Telephone | 540-380-3130
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Fax | 540-380-3784
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Provider Business Mailing Address
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Address Line | 5200 VIRGINIA WAY L & C DEPARTMENT
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City | BRENTWOOD
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State | TN
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Zip | 37027-7569
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Country | US
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Telephone | 615-320-4214
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Fax | 866-944-3352
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Authorized Official
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Title or Position | CHIEF ACCOUNTING OFFICER
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Name | JOHN WINSTEL
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Credential |
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Telephone | 253-733-4501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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