RENAL TREATMENT CENTERS NORTHEAST INC (NPI# 1104095041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104095041 |
| Entity Type | Organization |
| Organization Name | RENAL TREATMENT CENTERS NORTHEAST INC |
| Other Organization Name | SOUTH BROAD STREET DIALYSIS |
| Practice Address |
1172 S Broad St Philadelphia PA 19146-3142 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 2158756720 |
| Practice Fax Number | 2158756721 |
| Mailing Telephone | 6153416410 |
| Mailing Fax Number | 8886628259 |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2020-06-17 |
| 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 | 100729430 0033 | 05 |
| Other Name | Type Code |
|---|---|
| South Broad Street Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982634333 | Renal Treatment Centers Northeast Inc | Clinic/Center | 2121 Us Highway 22, Bound Brook, NJ 08805-1546 | 2006-07-03 |
| 1518929280 | Renal Treatment Centers Northeast Inc | Clinic/Center | 109 Dickinson St, Philadelphia, PA 19147-6107 | 2006-04-06 |
| 1295797058 | Renal Treatment Centers Northeast Inc | Clinic/Center | 518 Knorr St, Philadelphia, PA 19111-4604 | 2006-04-05 |
| 1598727372 | Renal Treatment Centers Northeast Inc | Clinic/Center | 185 Delaware Ave, Ste C, Palmerton, PA 18071-1716 | 2006-04-05 |
| 1841252889 | Renal Treatment Centers Northeast Inc | Clinic/Center | 3243 Lincoln Hwy, Thorndale, PA 19372-1012 | 2006-04-05 |
| 1255307336 | Renal Treatment Centers Northeast Inc | Clinic/Center | 605 W Newport Pike, Newport, DE 19804-3235 | 2006-02-27 |
| 1942393863 | Renal Treatment Centers Northeast Inc | Clinic/Center | 657 Willow Grove St, West Wing Medical Plaza Ste 202, Hackettstown, NJ 07840-1713 | 2006-10-02 |
| 1407818198 | Renal Treatment Centers Northeast Inc | Clinic/Center | 1 Medical Center Blvd, Ste 120, Chester, PA 19013-3902 | 2006-04-06 |
| 1821050667 | Renal Treatment Centers Northeast Inc | Clinic/Center | 100 Plaza Ct, Ste B, East Stroudsburg, PA 18301-8258 | 2006-04-05 |
| 1386606267 | Renal Treatment Centers Northeast Inc | Clinic/Center | 611 Electric Ave, Lewistown, PA 17044-1128 | 2006-04-05 |
| Street Address |
1172 S BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19146-3142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114545977 | Puentes De Salvd | Clinic/Center | 1700 South Street, Philadelphia, PA 19146 | 2020-07-08 |
| 1407480155 | Mutiat Ajibade | Nurse Practitioner | 1401 S. 31 Street, Phialdelphia, PA 19146 | 2020-03-02 |
| 1003453952 | Bridget Smith | Psychologist | Stratton Hall, 3201 Chestnut St., 2nd Floor, Philadelphia, PA 19146 | 2019-12-10 |
| 1730678012 | Christina Martindale | Nurse Anesthetist, Certified Registered | 917 S 15th Street, Philadelphia, PA 19146 | 2018-05-02 |
| 1598289456 | Allison Ortolano | Speech-Language Pathologist | 1933 Montrose St., Philadelphia, PA 19146 | 2017-08-01 |
| 1033630116 | Jami F Young | Psychologist | 2716 South Street, Behavioral Health 8/8473, Philadelphia, PA 19146 | 2017-06-29 |
| 1336678788 | Joshua Ryan Fidler | Occupational Therapist | 2223 Wharton Street, Philadelphia, PA 19146 | 2017-06-08 |
| 1912357930 | Mei Lan Natalie Lau | Pharmacist | 3000-02 Reed Street, Philadelphia, PA 19146 | 2016-06-21 |
| 1417354887 | Brandy Mitchell | Specialist | 1608 Webster Street, Philadelphia, PA 19146 | 2014-12-01 |
| 1942638101 | Woong Yi | Pharmacist | 1155 S.mole St, Philadelphia, PA 19146 | 2013-10-28 |
| Find all providers in zip 19146 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1235795204 | Isd Renal Inc | Clinic/Center | 4952 Parkside Ave, Philadelphia, PA 19131 | 2019-05-15 |
| 1306322516 | Isd Renal, Inc | Clinic/Center | 6501 Roosevelt Blvd, Ste 6581, Philadelphia, PA 19149-2918 | 2018-07-11 |
| 1093229809 | Northeast Philadelphia Dialysis Center LLC | Clinic/Center | 9815 Roosevelt Blvd Ste 1-a, Philadelphia, PA 19114-1035 | 2017-12-01 |
| 1134640949 | Isd Renal Inc | Clinic/Center | 1236 N 26th St, Philadelphia, PA 19121-4602 | 2017-06-30 |
| 1851812069 | Total Renal Care Inc | Clinic/Center | 235 W Chelten Ave, Philadelphia, PA 19144-3802 | 2017-06-28 |
| 1710411707 | Rcg Mississippi, Inc. | Clinic/Center | 1100 Central Drive, Philadelphia, MS 39350 | 2017-04-17 |
| 1609249986 | Bio-medical Applications of Pennsylvania, Inc. | Clinic/Center | 301 W Chelten Ave, Philadelphia, PA 19144-3804 | 2015-11-09 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19146 |
Please comment or provide details below to improve the information on RENAL TREATMENT CENTERS NORTHEAST INC.
| 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.