Organization · Type 2 NPI

Isd Renal Inc

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

NPI number 1235795204 Active

Practice location

4952 Parkside Ave
Philadelphia, PA 19131-4746

Call (215) 871-0810 Map

Fax (215) 871-0817

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: 1235795204
Entity type: Organization (Type 2)
Issued: May 15, 2019
Last updated: Oct 23, 2026
Status: Active

Other names

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Cedar Grove Dialysis · doing business as
Cedar Grove Dialysis · doing business as

Authorized official

Samuel Wey
VP, Licensure & Certification
(615) 341-6641

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About NPI 1235795204

Isd Renal Inc's National Provider Identifier is 1235795204, issued on May 15, 2019. 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 Oct 23, 2026.