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NPI Code Detail

MEDICARE: BIO-MEDICAL APPLICATIONS OF PENNSYLVANIA, INC.

MEDICARE: BIO-MEDICAL APPLICATIONS OF PENNSYLVANIA, INC.
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1710081583
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIO-MEDICAL APPLICATIONS OF PENNSYLVANIA, INC.
Provider Business Mailing Address
First Line : 1900 S BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145-2304
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1900 S BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145-2304
Country : US
Telephone Number : 215-339-4482
Fax Number :
Authorized Official
Title or Position : TREASURER
Name : MARK FAWCETT
Credential :
Telephone Number : 781-402-9000
Provider Enumeration Date : 09/12/2006
Last Update Date : 08/22/2020

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