NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC NPI 1114922416

NPI Information

NPI: 1114922416
Provider Name: NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC

Doing Business As: WILLIAMSPORT DIALYSIS CLINIC

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1660 SYCAMORE RD
MONTOURSVILLE, PA
ZIP 17754
Phone: (570) 329-3300
Get Directions

NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC is an end-stage renal disease (esrd) treatment clinic center in Montoursville, PA. NORTH CENTRAL PENNSYLVANIA DIALYSIS CLINICS LLC NPI is 1114922416. The provider is registered as an organization entity type.
The provider Is Doing Business As Williamsport Dialysis Clinic.

The provider's business location address is:

1660 SYCAMORE RD
MONTOURSVILLE, PA
ZIP 17754-314
Phone: (570) 329-3300
Fax: (570) 329-1069

The provider's authorized official is Chester A. Amedia .
The authorized official title is Ceo and has the following contact phone number (330) 781-6212.

The CLIA number assigned to this NPI record is 39D2167167 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/15/2005 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1837223	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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