Organization
KIDNEYCARE RX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA M GOLOMB (VICE PRESIDENT)
(650) 696-8900
Entity
Organization
Contact information
Practice address
2944 S NORFOLK ST, SAN MATEO, CA 94403-2018
(650) 349-1451
(650) 349-2570
Mailing address
1350 OLD BAYSHORE HWY, SUITE 777, BURLINGAME, CA 94010-1823
(650) 696-8900
(866) 208-4462
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHY47005
CA
332BD1200X
Dialysis Equipment & Supplies (DME)
PHY47005
CA
333600000X
Pharmacy
PHY47005
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY47005
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA470050
—
CA
Enumeration date
07/14/2008
Last updated
07/14/2008
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