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Organization

REVAMP - ENCARDIA, LLC

Active
Other names
ReVaMP Heart & Vascular Surgery Center
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization

Contact information

Practice address
510 N BROAD ST STE 201, PHILADELPHIA, PA 19130-4379
(267) 908-9520
Mailing address
510 N BROAD ST STE 201, PHILADELPHIA, PA 19130-4379
(267) 908-9520

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
06/17/2024
Last updated
01/08/2026
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