Dca of Wellsboro, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

DCA OF WELLSBORO, LLC

Doing business as

U.S. Renal Care Wellsboro Dialysis

Practice address

70 Plaza LN
Wellsboro, PA 16901-1766

Phone

(570) 724-3188

Fax

(570) 724-1971

NPI assigned

Jan 7, 2014

Last updated

Jan 7, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Wellsboro Dialysis Doing business as

Part of

US Renal Care Inc

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1073935391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713158",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452713158",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PLAZA LN",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011766",
            "telephone_number": "570-724-3188",
            "fax_number": "570-724-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DCA OF WELLSBORO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Wellsboro Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crossroads Counseling, Inc.
• Christal Crowell, DPT
• Pamela M Cummings, PTA
• Elizabeth Kull Czako, CFNP
• Leonard E. Dale II, MD
• Crystal Deitrick, M.ED., LPC
• Mitchell Dent, DNP, CRNA
• Trudi M Dibble, PT ASSISTANT
• Autumn Elizabeth Dietrich
• Doan Med LLC (Tioga Wellness & Vitality)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wellsboro, PA
• Providers in Wellsboro, PA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.