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Organization

ISD RENAL INC

Active
Other names
Northern Philadelphia Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
5933 N BROAD ST, PHILADELPHIA, PA 19141-1801
(215) 549-5000
(215) 549-9558
Mailing address
5200 VIRGINIA WAY, L & C DEPT, BRENTWOOD, TN 37027-7569

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
1020290100003
PA
Enumeration date
05/26/2006
Last updated
01/22/2026
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