Winslow Dialysis Center, LLC

Primary specialty

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

License

23949 Issued in NJ

Legal business name

WINSLOW DIALYSIS CENTER, LLC

Practice address

510 2-A Williamstown Road
Sicklerville, NJ 08081

Phone

(856) 728-2811

Fax

(856) 728-2911

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

William J Valle

Title

Ceo/President

Phone

(610) 495-8900

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1245263029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 COMMERCE CT",
            "address_2": "SUITE 104",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643483",
            "telephone_number": "610-495-8900",
            "fax_number": "610-495-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 2-A WILLIAMSTOWN ROAD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "08081",
            "telephone_number": "856-728-2811",
            "fax_number": "856-728-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINSLOW DIALYSIS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "VALLE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "610-495-8900"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "23949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BLUE CROSS",
            "identifier": "312585",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106071",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Wilson
• Tracey Wilson
• Tyra Wilson
• Wayne Wilson
• Sandra Rose Winiewicz, DPM
• Winslow Medical Supply
• Winslow Pharmacy
• Winslow Primary Care Associates, PC
• Bobby J Woods, PTA
• Work Right Now

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Sicklerville, NJ
• Providers in Sicklerville, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; 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.