ETOWAH DIALYSIS LLC (NPI# 1033687413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033687413 |
| Entity Type | Organization |
| Organization Name | ETOWAH DIALYSIS LLC |
| Other Organization Name | ST LUKE'S TAMAQUA DIALYSIS |
| Practice Address |
1215 E Broad St Ste 20 Tamaqua PA 18252-2229 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 5706683480 |
| Practice Fax Number | 5706683483 |
| Mailing Telephone | 6153416410 |
| Mailing Fax Number | 8886628259 |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2020-08-03 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 102924317 | 05 |
| Other Name | Type Code |
|---|---|
| St Luke's Tamaqua Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659830800 | Etowah Dialysis LLC | Clinic/Center | 2550 Route 100, Ste 2, Macungie, PA 18062-0000 | 2019-03-18 |
| 1376909515 | Etowah Dialysis LLC | Clinic/Center | 1901 Hamilton St, Ste 200, Allentown, PA 18104-6460 | 2016-01-04 |
| 1770948838 | Etowah Dialysis LLC | Clinic/Center | 1220 3rd St, Whitehall, PA 18052-4905 | 2015-12-16 |
| 1891121166 | Etowah Dialysis LLC | Clinic/Center | 1021 Park Ave, Quakertown, PA 18951-1573 | 2013-09-18 |
| 1457787715 | Etowah Dialysis LLC | Clinic/Center | 1425 8th Ave, Bethlehem, PA 18018-2256 | 2013-09-18 |
| 1790111060 | Etowah Dialysis LLC | Clinic/Center | 1901 Hamilton St, Ste 100, Allentown, PA 18104-6460 | 2013-09-18 |
| Street Address |
1215 E BROAD ST STE 20 |
| City | TAMAQUA |
| State | PA |
| Zip Code | 18252-2229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508034851 | Fresenius Medical Care Comprehensive Ckd Services Inc | Clinic/Center | 1215 E Broad St, Ckd Services of Tamaqua, Tamaqua, PA 18252-2229 | 2008-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841351046 | Schuylkill Cardiology Consultants, P.C. | Internal Medicine | 17 West Broad Street, Tamaqua, PA 18252 | 2006-12-12 |
| 1982700282 | Jessica Herness | Physical Therapist | 219 Claremont Avenue, Tamaqua, PA 18252 | 2006-09-15 |
| 1245272392 | Bio-medical Applications of Pennsylvania, Inc | Clinic/Center | Tamaqua Plaza Shopping Ctr., Rte. 209 S., Fmc of Tamaqua Ckd Services, Tamaqua, PA 18252 | 2006-06-12 |
| 1891777900 | Frank J Bobick | Ophthalmology | 37 Medical Crossing Rd, Tamaqua, PA 18252 | 2005-11-15 |
| 1811979958 | Angela G Houser | Ophthalmology | 37 Medical Crossing Road, Tamaqua, PA 18252 | 2005-11-15 |
| 1770028136 | St. Luke's Physician Group Inc. | Otolaryngology | 120 Pine St, Suite B, Tamaqua, PA 18252 | 2016-12-21 |
| 1285883553 | Carbon - Schuylkill Community Hospital Inc | Clinic/Center | 34 S Railroad St, Tamaqua, PA 18252 | 2008-09-11 |
| 1629109053 | Wal-mart Stores East, L.p. | Technician/Technologist | 35 Plaza Dr, Tamaqua, PA 18252 | 2007-03-08 |
| 1649366857 | Charles E Fey | Optometrist | 37 Medical Crossing Road, Tamaqua, PA 18252 | 2006-10-05 |
| 1366536047 | Joseph S Pancher | Optometrist | 37 Medical Crossing Road, Tamaqua, PA 18252 | 2006-10-03 |
| Find all providers in zip 18252 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508034851 | Fresenius Medical Care Comprehensive Ckd Services Inc | Clinic/Center | 1215 E Broad St, Ckd Services of Tamaqua, Tamaqua, PA 18252-2229 | 2008-02-20 |
| 1326143124 | Bio-medical Applications of Pennsylvania Inc | Clinic/Center | 1215 E. Broad St., Tamaqua Plaza Shopping Center,rte 209 South, Tamaqua, PA 18252-2229 | 2006-09-14 |
| 1245272392 | Bio-medical Applications of Pennsylvania, Inc | Clinic/Center | Tamaqua Plaza Shopping Ctr., Rte. 209 S., Fmc of Tamaqua Ckd Services, Tamaqua, PA 18252 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157123 | Fresenius Medical Care Southwest Pittsburgh, LLC | Clinic/Center | 3 Robinson Plz Ste 110, Pittsburgh, PA 15205-1018 | 2020-08-31 |
| 1295344307 | Isd Renal Inc | Clinic/Center | 1930 S Broad St Unit 7, Philadelphia, PA 19145-2328 | 2020-07-24 |
| 1225647332 | Isd Renal Inc | Clinic/Center | 230 N Broad St Bldg 12th, Philadelphia, PA 19102-1121 | 2020-07-24 |
| 1336758549 | Isd Renal Inc | Clinic/Center | 1300 W Lehigh Ave Ste 106, Philadelphia, PA 19132-2764 | 2020-07-24 |
| 1992323976 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 300 Cedar Ridge Dr Ste 302, Pittsburgh, PA 15205-1159 | 2020-07-07 |
| 1750906574 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 9333 State Route 61, Coal Township, PA 17866-4170 | 2020-06-09 |
| 1407479124 | Dialysis Clinic Inc | Clinic/Center | 1603 Carmody Ct Ste 103, Sewickley, PA 15143-8859 | 2020-05-28 |
| 1154944486 | Fresenius Medical Care Wyomissing, LLC | Clinic/Center | 656 Berkshire Blvd, Wyomissing, PA 19610 | 2020-05-21 |
| 1336774181 | Elkonson Dialysis LLC | Clinic/Center | 350 Tri County Ln, Rostraver Township, PA 15012-1990 | 2020-03-11 |
| 1417599168 | Renal Treatment Centers - Mid-atlantic Inc | Clinic/Center | 8000c Derry St, Harrisburg, PA 17111-5200 | 2019-10-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.