Organization
BELMONT COURT DIALYSIS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER L BAMGBOSE (BILLING SUPERVISOR)
(610) 630-1515
Entity
Organization
Contact information
Practice address
183B BRISTOL OXFORD VALLEY RD, LANGHORNE, PA 19047-3030
(215) 269-6864
(215) 547-4598
Mailing address
2500 BOULEVARD OF THE GENERALS, FAIRLESS HILLS, NORRISTOWN, PA 19403-3692
(610) 630-1515
(610) 630-6839
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000485000
INDEPENDENCE BLUE CROSS
PA
01
—
08380
HEALTH/SENIOR PARTNERS
PA
05
—
1007285120005
—
PA
01
—
1021750
KEYSTONE MERCY
PA
01
—
50745
AETNA US HEALTHCARE
PA
01
—
PPA06037
STATE RENAL
PA
Enumeration date
10/06/2006
Last updated
09/04/2007
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