THE DIALYSIS CENTER OF WEST PHILADELPHIA LLC (NPI# 1184091142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184091142 |
| Entity Type | Organization |
| Organization Name | THE DIALYSIS CENTER OF WEST PHILADELPHIA LLC |
| Other Organization Name | THE DIALYSIS CENTER OF WEST PHILADELPHIA AT MILL CREEK |
| Practice Address |
4800 Brown St Ste 201 Philadelphia PA 19139-2106 |
| Mailing Address |
4800 Brown St Suite 201 Philadelphia PA 19139-2126 |
| Practice Telephone | 2155814993 |
| Practice Fax Number | 2158831573 |
| Mailing Telephone | 2155814993 |
| Mailing Fax Number | 2158831573 |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | SHARI K COUSINS (SR. VP OF CLINICAL & REGULATORY) |
| Authorized Official Telephone | 9789223080 |
| 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 | 1032188170001 | 05 |
| Other Name | Type Code |
|---|---|
| The Dialysis Center of West Philadelphia at Mill Creek | Doing Business As Name - Organization |
| Street Address |
4800 BROWN ST STE 201 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19139-2106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566621 | Isd Renal Inc | Clinic/Center | 4800 Brown St Ste 201, Philadelphia, PA 19139-2105 | 2020-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598378663 | Suzanne Banning Anderson | Social Worker | Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 | 2020-08-28 |
| 1770192890 | Michael Pappano LLC | Social Worker | 31 South 51st St, Philadelphia, PA 19139 | 2020-07-24 |
| 1912419581 | Christina Lipuma | Dietitian, Registered | 5210 Haverford Ave, Philadelphia, PA 19139 | 2017-11-03 |
| 1538515564 | New Vitae Inc | Public Health or Welfare | 27 S 55th Street, Philadelphia, PA 19139 | 2016-05-09 |
| 1982058681 | Phyllis Mwaura | In Home Supportive Care | 5338 Vine Street, Basement, Philadelphia, PA 19139 | 2016-04-19 |
| 1861879322 | Barbara Joette Hegarty | Counselor | 4508 Chestnut Street, Philadelphia, PA 19139 | 2015-05-04 |
| 1336533454 | Julie Magallanes-montone | Family Medicine | 5201 Haverford Avenue, Philadelphia, PA 19139 | 2015-03-26 |
| 1134494909 | The Children's Hospital of Philadelphia | Pediatrics | 4865 Market Street, Philadelphia, PA 19139 | 2012-03-13 |
| 1467757443 | Nouman Bashir | Dentist | 5139 Chestnut Stree, Philadelphia, PA 19139 | 2011-01-21 |
| 1720396732 | Serena Denise Johnson | Contractor | 5151a Walnut Street, Philadelphia, PA 19139 | 2010-09-24 |
| Find all providers in zip 19139 | ||||
| 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 | 19139 |
Please comment or provide details below to improve the information on THE DIALYSIS CENTER OF WEST PHILADELPHIA LLC.
| 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.