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Organization

THE DIALYSIS UNIT OF CENTER CITY PHILADELPHIA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHARI K COUSINS (SR. VP OF CLINICAL & REGULATORY)
(978) 922-3080
Entity
Organization

Contact information

Practice address
230 N BROAD ST, 12 FLOOR, PHILADELPHIA, PA 19102-1121
(215) 563-9383
(215) 563-9429
Mailing address
230 N BROAD ST, 12 FLOOR, PHILADELPHIA, PA 19102-1121
(215) 563-9383
(215) 563-9429

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
1030987550001
PA
Enumeration date
10/02/2015
Last updated
03/16/2020
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