Organization
ISD RENAL, INC
Active
Other names
Harbison Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
6501 ROOSEVELT BLVD, STE 6581, PHILADELPHIA, PA 19149-2918
(215) 288-4671
(215) 533-4501
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
—
102029010
—
PA
Enumeration date
07/11/2018
Last updated
02/12/2024
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