Organization Name: | DIALYSIS SERVICES OF PENNSYLVANIA, INC- LEMOYNE |
NPI Number: | 1366405847 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEPHEN EVERETT (CEO) |
Mailing Address: | 27 Miller St Suite 1 Lemoyne |
State: | PA US |
Postal Code: | 170431521 |
Phone Number: | 7177306011 |
Fax Number: | 7177309086 |
NPI Enumeration Date: | 04/07/2006 |
NPI Last Update Date: | 06/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |