Organization
BELMONT COURT DIALYSIS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER L BAMGBOSE (BILLING SUPERVISOR)
61063015151
Entity
Organization
Contact information
Practice address
2200 MICHENER ST STE 20-21, PHILADELPHIA, PA 19115-4374
(215) 676-8800
(215) 676-4950
Mailing address
2500 BOULEVARD OF THE GENERALS, NORTHEAST CAMPUS, 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
—
0000357000
INDEPENDENCE BLUE CROSS
PA
01
—
08380
HEALTH/SENIOR PARTNERS
PA
05
—
1007285120001
—
PA
01
—
1021750
KEYSTONE MERCY
PA
01
—
50745
AETNA US HEALTHCARE
PA
01
—
PPA06037
STATE RENAL
PA
01
—
X000260701
AMERICHOICE
PA
Enumeration date
10/06/2006
Last updated
09/04/2007
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