| NPI | 1891780250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L BAMGBOSE Billing Supervisor 610-630-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2007-09-04 |