Organization
ISD RENAL INC
Active
Other names
Merchantville Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
5000 N CRESCENT BLVD, STE 1A, PENNSAUKEN, NJ 08109-2151
(856) 910-8798
(856) 910-8794
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6410
(888) 662-8259
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06511117
—
NJ
Enumeration date
12/08/2017
Last updated
01/10/2024
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