St Luke'S Tamaqua Dialysis

LBN: Etowah Dialysis Llc
St Luke'S Tamaqua Dialysis is an health care organization with primary practice located at 1215 E Broad St Ste 20, Tamaqua PA 18252-2229. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Etowah Dialysis Llc can be contacted via phone (570) 668-3480, or through Wey, Samuel T via phone (615) 341-6641.

Contact Information

Primary practice address
1215 E Broad St Ste 20 Tamaqua PA 18252-2229
Phone: (570) 668-3480
Fax: (570) 668-3483
Website:
Map and Directions
Authorized official contact:
Name: Wey, Samuel T
Phone: (615) 341-6641

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1033687413
LBN Legal business name Etowah Dialysis Llc
DBA Doing business as St Luke'S Tamaqua Dialysis
Authorized official Wey, Samuel T
Entity Organization
Organization subpart 1 No
Enumeration date Nov 5th, 2018
Last updated May 2nd, 2024 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033687413 NPPES
Pennsylvania MEDICAID 102924317

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