DAVITA OF GREENBRIER NPI 1003001215

Nursing Care in Lewisburg, WV

About DAVITA OF GREENBRIER

Davita Of Greenbrier is a provider in Lewisburg, WV. The NPI number assigned to this provider is 1003001215. The practitioner's primary taxonomy code is Nursing Care (251J00000X). The provider is registered as an organization and their NPI record was last updated 11 years ago. The provider's former legal business name is Gambro Healthcare.

NPI

1003001215

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameDAVITA OF GREENBRIER
Provider Location Address129 SENECA TRL LEWISBURG, WV 24901 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address129 SENECA TRL LEWISBURG, WV 24901 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameGAMBRO HEALTHCARE Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeFormer Legal Business Name (4)
Enumeration Date09-11-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date09-11-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code251J00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationNursing Care
TypeAgencies
License No.030330
License StateWV
Taxonomy DescriptionA Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.

Business Address

DAVITA OF GREENBRIER
129 SENECA TRL
LEWISBURG, WV
ZIP 24901
Phone: (304) 645-4806
Fax: (304) 647-3941

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Mailing Address

DAVITA OF GREENBRIER
129 SENECA TRL
LEWISBURG, WV
ZIP 24901
Phone: (304) 645-4806
Fax: (304) 647-3941

Authorized Official

Authorized Official Name MARILYN KELLEY RN Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleFACILITY ADMINISTRATOR
Authorized Official Phone(304) 645-4806

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0005742000MEDICAID (05)WV
Previous NPI
1003001207
Next NPI
1003001223