ETOWAH DIALYSIS LLC (NPI# 1770948838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770948838 |
| Entity Type | Organization |
| Organization Name | ETOWAH DIALYSIS LLC |
| Other Organization Name | ST LUKES WHITEHALL DIALYSIS |
| Practice Address |
1220 3rd St Whitehall PA 18052-4905 |
| Mailing Address |
5200 Virginia Way L & C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 6102661706 |
| Practice Fax Number | 6102661574 |
| Mailing Telephone | 6153416410 |
| Mailing Fax Number | 8886628259 |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2020-08-03 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1029243170004 | 05 |
| Other Name | Type Code |
|---|---|
| St Lukes Whitehall Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659830800 | Etowah Dialysis LLC | Clinic/Center | 2550 Route 100, Ste 2, Macungie, PA 18062-0000 | 2019-03-18 |
| 1033687413 | Etowah Dialysis LLC | Clinic/Center | 1215 E Broad St, Ste 20, Tamaqua, PA 18252-2229 | 2018-11-05 |
| 1376909515 | Etowah Dialysis LLC | Clinic/Center | 1901 Hamilton St, Ste 200, Allentown, PA 18104-6460 | 2016-01-04 |
| 1891121166 | Etowah Dialysis LLC | Clinic/Center | 1021 Park Ave, Quakertown, PA 18951-1573 | 2013-09-18 |
| 1457787715 | Etowah Dialysis LLC | Clinic/Center | 1425 8th Ave, Bethlehem, PA 18018-2256 | 2013-09-18 |
| 1790111060 | Etowah Dialysis LLC | Clinic/Center | 1901 Hamilton St, Ste 100, Allentown, PA 18104-6460 | 2013-09-18 |
| Street Address |
1220 3RD ST |
| City | WHITEHALL |
| State | PA |
| Zip Code | 18052-4905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619950920 | Glenn S. Weiss | Pharmacist | 1220 3rd St, Whitehall, PA 18052-4905 | 2005-11-22 |
| 1700838984 | Hilbert's Pharmacy Inc. | Pharmacy | 1220 3rd St, Whitehall, PA 18052-4905 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228870 | Alexandra Podlesny | Family Medicine | 1401 Fairmount St, Whitehall, PA 18052 | 2020-06-05 |
| 1346894805 | Christopher Guidon | Physician Assistant | 2402 Macarthur Rd., Whitehall, PA 18052 | 2019-08-01 |
| 1255824314 | Kenneth C Fulton-resig | Counselor | 4772 Main Street, Whitehall, PA 18052 | 2018-06-12 |
| 1023505294 | St. Luke's Physician Group, Inc. | Internal Medicine | 2416 3rd Avenue, Whitehall, PA 18052 | 2018-04-13 |
| 1831617869 | Veronica Taylor | Specialist | 4150 Red Bud Dr W, Whitehall, PA 18052 | 2017-08-30 |
| 1467800466 | Princy Ann Koshy | Family Medicine | 3691 Crescent Ct E Ste 201, Whitehall, PA 18052 | 2016-05-31 |
| 1649642612 | Renae N Defreitas | Nurse Practitioner | 2402 Macarthur Rd, Whitehall, PA 18052 | 2015-10-29 |
| 1063718856 | Christy Lynn Kroboth | Registered Nurse | 3000 Fellowship Drive, Whitehall, PA 18052 | 2011-01-27 |
| 1003134818 | Bruce C Trout | Pharmacist | 3671 Crescent Ct E., Whitehall, PA 18052 | 2010-05-04 |
| 1982921359 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 400 Lehigh Valley Mall, Whitehall, PA 18052 | 2010-04-26 |
| Find all providers in zip 18052 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639115744 | Bio-medical Applications of Pennsylvania, Inc. | Clinic/Center | 1320 Mickley Rd., Whitehall, PA 18052-5701 | 2006-06-20 |
| 1437105285 | Bio-medical Applications of Pennsylvania, Inc. | Clinic/Center | 601 8th St, Bma of Fullerton - Ckd Services, Whitehall, PA 18052-5701 | 2006-05-25 |
| 1245408681 | Fresenius Medical Care Comprehensive Ckd Services Inc | Clinic/Center | 601 8th St, Ckd Services of Fullerton, Whitehall, PA 18052-5701 | 2008-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157123 | Fresenius Medical Care Southwest Pittsburgh, LLC | Clinic/Center | 3 Robinson Plz Ste 110, Pittsburgh, PA 15205-1018 | 2020-08-31 |
| 1295344307 | Isd Renal Inc | Clinic/Center | 1930 S Broad St Unit 7, Philadelphia, PA 19145-2328 | 2020-07-24 |
| 1225647332 | Isd Renal Inc | Clinic/Center | 230 N Broad St Bldg 12th, Philadelphia, PA 19102-1121 | 2020-07-24 |
| 1336758549 | Isd Renal Inc | Clinic/Center | 1300 W Lehigh Ave Ste 106, Philadelphia, PA 19132-2764 | 2020-07-24 |
| 1992323976 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 300 Cedar Ridge Dr Ste 302, Pittsburgh, PA 15205-1159 | 2020-07-07 |
| 1750906574 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 9333 State Route 61, Coal Township, PA 17866-4170 | 2020-06-09 |
| 1407479124 | Dialysis Clinic Inc | Clinic/Center | 1603 Carmody Ct Ste 103, Sewickley, PA 15143-8859 | 2020-05-28 |
| 1154944486 | Fresenius Medical Care Wyomissing, LLC | Clinic/Center | 656 Berkshire Blvd, Wyomissing, PA 19610 | 2020-05-21 |
| 1336774181 | Elkonson Dialysis LLC | Clinic/Center | 350 Tri County Ln, Rostraver Township, PA 15012-1990 | 2020-03-11 |
| 1417599168 | Renal Treatment Centers - Mid-atlantic Inc | Clinic/Center | 8000c Derry St, Harrisburg, PA 17111-5200 | 2019-10-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.