Organization
ISD RENAL INC
Active
Other names
North Wales Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1551 S VALLEY FORGE RD, LANSDALE, PA 19446-5461
(215) 361-6192
(215) 361-2032
Mailing address
5200 VIRGINIA WAY, ATT: 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
—
1020290100004
—
PA
Enumeration date
01/22/2018
Last updated
09/18/2023
Update your record
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