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General NPI Number Information
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NPI Number | 1477155638
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Entity Type | Organization
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Legal Business Name | PENNSYLVANIA KIDNEY CARE, P.C.
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1500 WALNUT ST STE 603
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3516
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Country | US
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Telephone | 267-754-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 17TH ST STE 1000
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City | DENVER
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State | CO
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Zip | 80202-2043
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Country | US
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Telephone | 980-443-4852
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Fax |
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Authorized Official
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Title or Position | VP, CENTRAL SERVICES
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Name | ALLIE SILVER
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Credential |
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Telephone | 980-443-4852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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