RENAL TREATMENT CENTERS - MID-ATLANTIC INC. NPI 1629546577

NPI Information

  • NPI: 1629546577
  • Provider Name: RENAL TREATMENT CENTERS - MID-ATLANTIC, INC.
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: DUKE STREET DIALYSIS
  • CLIA Number: 39D2159476
  • Address: 901 E MAIN ST
    STE 12
    PALMYRA, PA
    ZIP 17078
  • Phone: (717) 832-1390

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NPI Details

RENAL TREATMENT CENTERS - MID-ATLANTIC, INC. is an end-stage renal disease (esrd) treatment clinic center in Palmyra, PA. RENAL TREATMENT CENTERS - MID-ATLANTIC, INC. NPI is 1629546577. The provider is registered as an organization entity type.
The provider Is Doing Business As Duke Street Dialysis.

The provider's business location address is:

901 E MAIN ST
STE 12
PALMYRA, PA
ZIP 17078-923
Phone: (717) 832-1390
Fax: (717) 832-1395

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp, Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 39D2159476 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/8/2018 and was last updated on 4/8/2024.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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
1103444602MEDICAIDPENNSYLVANIA

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: 3/30/2025

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