# KEYSTONE MOBILE PARTNERS, LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Keystone Kidney Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083898787
- **Authorized official:** MR. MICHAEL A DERNOGA (EXEC. DIRECTOR)
- **Authorized official phone:** (215) 675-9900

## Contact information

- **Practice address:** 2701 BLAIR MILL RD, STE. 30, WILLOW GROVE, PA 19090-1041
- **Practice address phone:** (215) 675-9900
- **Practice address fax:** (215) 675-4096
- **Mailing address:** 2701 BLAIR MILL RD, STE. 30, WILLOW GROVE, PA 19090-1041
- **Mailing address phone:** (215) 675-9900
- **Mailing address fax:** (215) 675-4096

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 15331501 | PA | Yes |

## Other

- **Enumeration date:** 12/18/2007
- **Last updated:** 12/18/2007