MEDICARE: ST. JOSEPH'S KIDNEY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1437183589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. JOSEPH'S KIDNEY CENTER

Provider Business Mailing Address
First Line	:	555 E MARKET ST
Second Line	:
City	:	ELMIRA
State	:	NY
Zip	:	14901-3223
Country	:	US
Telephone Number	:	607-733-6541
Fax Number	:	607-737-2624

Provider Business Practice Location Address
First Line	:	200 MADISON AVE STE 1B
Second Line	:
City	:	ELMIRA
State	:	NY
Zip	:	14901-3219
Country	:	US
Telephone Number	:	607-733-6541
Fax Number	:	607-737-2624

Authorized Official
Title or Position	:	DIRECTOR OF PATIENT FINANCIAL SERVI
Name	:	MR. DONALD J VANGORDER
Credential	:
Telephone Number	:	607-733-6541

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	12/03/2008

Similar Medicare Providers

1770983652 — MRS. ANGELA DIXON CRNP
Practice Location Address:

200 MADISON AVE STE 1D
ELMIRA, NY
14901-3219

Practice Phone: 607-873-1832
Practice Fax: 607-873-1833

1275508533 — DR. KIMBERLY JANE SILVERS MD
Practice Location Address:

200 MADISON AVE STE 1D
ELMIRA, NY
14901-3219

Practice Phone: 607-873-1832
Practice Fax: 607-873-1833

1780630830 — JOHN WESTON D.O.
Practice Location Address:

200 MADISON AVE FL 3
ELMIRA, NY
14901-3219

Practice Phone: 607-734-1581
Practice Fax: 607-734-0972

1477563781 — DR. LORRIE PENFIELD M.D.
Practice Location Address:

200 MADISON AVENUE , 3RD FLOOR
ELMIRA, NY
14901-3219

Practice Phone: 607-734-1581
Practice Fax: 607-767-4137

1114020237 — DR. KEITH W. PARKER MD
Practice Location Address:

200 MADISON AVE FL 3
ELMIRA, NY
14901-3219

Practice Phone: 607-734-1581
Practice Fax: 607-734-0972

1356440473 — THOMAS B. COSS RPA-C
Practice Location Address:

200 MADISON AVE FL 3
ELMIRA, NY
14901-3219

Practice Phone: 607-734-1581
Practice Fax: 607-734-0972

Directions to “ST. JOSEPH'S KIDNEY CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.