Organization · Type 2 NPI

Isd Renal Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Philadelphia, PA

NPI number 1134640949 Active

Practice location

1236 N 26th St
Philadelphia, PA 19121-4602

Call (215) 763-3974 Map

Fax (215) 765-1494

Mailing address

5200 Virginia Way, L & C Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1134640949
Entity type: Organization (Type 2)
Issued: Jun 30, 2017
Last updated: Aug 7, 2020
Status: Active

Other names

<unavail>
Fairmount Dialysis · doing business as
Fairmount Dialysis · doing business as

Authorized official

John D Winstel
Chief Accounting Officer
(253) 733-4501

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About NPI 1134640949

Isd Renal Inc's National Provider Identifier is 1134640949, issued on Jun 30, 2017. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Philadelphia, PA. The record was last updated on Aug 7, 2020.