Organization
US VASCULAR ACCESS CENTER OF PHILADELPHIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE WELLS (VICE-PRESIDENT)
(770) 955-2226
Entity
Organization
Contact information
Practice address
4220 MARKET ST, SECOND FLOOR, PHILADELPHIA, PA 19104-3007
(215) 386-4959
(215) 386-4950
Mailing address
4220 MARKET ST, SECOND FLOOR, PHILADELPHIA, PA 19104-3007
(215) 386-4959
(215) 386-4950
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
20461501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20461501
STATE LICENSE
PA
Enumeration date
06/18/2007
Last updated
09/27/2007
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