NORTHEAST PHILADELPHIA DIALYSIS CENTER LLC is an end-stage renal disease (esrd) treatment clinic center in Philadelphia, PA. NORTHEAST PHILADELPHIA DIALYSIS CENTER LLC NPI is 1093229809. The provider is registered as an organization entity type.
The provider's business location address is:
9815 ROOSEVELT BLVD STE 1-A
PHILADELPHIA, PA
ZIP 19114-035
Phone: (215) 330-0494
Fax: (215) 330-0495
The provider's authorized official is Shari K Cousins .
The authorized official title is Sr. Vp Of Clinical & Regulatory and has the following contact phone number (978) 922-3080.
The CLIA number assigned to this NPI record is 39D2143413 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 12/1/2017 and was last updated on 3/17/2020.