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NPI Code Detail

MEDICARE: PHYSICIANS CHOICE DIALYSIS OF ALEXANDER CITY, LLC

MEDICARE: PHYSICIANS CHOICE DIALYSIS OF ALEXANDER CITY, LLC
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/Center12110AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1012-502OTHERALBLUE CROSS ALABAMA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861425621
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIANS CHOICE DIALYSIS OF ALEXANDER CITY, LLC
Provider Business Mailing Address
First Line : 211 COMMERCE CT
Second Line : SUITE 104
City : POTTSTOWN
State : PA
Zip : 19464-3483
Country : US
Telephone Number : 610-495-8900
Fax Number : 610-495-8560
Provider Business Practice Location Address
First Line : 3316 HIGHWAY 280 BYPASS
Second Line : SUITE G1
City : ALEXANDER CITY
State : AL
Zip : 35010-3369
Country : US
Telephone Number : 256-329-0638
Fax Number : 256-329-8934
Authorized Official
Title or Position : DIRECTOR OF CONTRACTS/HR
Name : MRS. RHONDA B. PALUMBO
Credential :
Telephone Number : 610-495-8900
Provider Enumeration Date : 07/07/2006
Last Update Date : 09/27/2007

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Directions to “PHYSICIANS CHOICE DIALYSIS OF ALEXANDER CITY, LLC ” Practice Location

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