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
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1578667440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIO-MEDICAL APPLICATIONS OF PENNSYLVANIA INC.

Provider Business Mailing Address
First Line	:	417 N 8TH ST
Second Line	:	FL 1
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-3916
Country	:	US
Telephone Number	:	215-413-3050
Fax Number	:	215-413-3056

Provider Business Practice Location Address
First Line	:	417 N 8TH ST
Second Line	:	FL 1
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-3916
Country	:	US
Telephone Number	:	215-413-3050
Fax Number	:	215-413-3056

Authorized Official
Title or Position	:	TREASURER
Name	:	MARK R FAWCETT
Credential	:
Telephone Number	:	781-699-9000

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	10/12/2016

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