Organization
CVS-SHC KIDNEY CARE HOME DIALYSIS OF PHILADELPHIA LLC
Active
Other names
CVS Kidney Care-Satellite Healthcare Ridley
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE VINCENT (PRESIDENT/COO)
(669) 266-6359
Entity
Organization
Contact information
Practice address
1939 MACDADE BOULEVARD, FOLSOM, PA 19033-1214
(610) 616-5555
(610) 461-3424
Mailing address
300 SANTANA ROW STE 300, SAN JOSE, CA 95128-2424
(669) 236-5947
(650) 625-6007
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
01
—
03312022
ASSUMED NAME
PA
Enumeration date
04/08/2022
Last updated
04/08/2022
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