US Vascular Access Center of Philadelphia, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

20461501 Issued in PA

Legal business name

US VASCULAR ACCESS CENTER OF PHILADELPHIA, LLC

Practice address

4220 Market St
Second Floor
Philadelphia, PA 19104-3007

Phone

(215) 386-4959

Fax

(215) 386-4950

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Debbie Wells

Title

Vice-President

Phone

(770) 955-2226

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1255536496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 MARKET ST",
            "address_2": "SECOND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043007",
            "telephone_number": "215-386-4959",
            "fax_number": "215-386-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 MARKET ST",
            "address_2": "SECOND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043007",
            "telephone_number": "215-386-4959",
            "fax_number": "215-386-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US VASCULAR ACCESS CENTER OF PHILADELPHIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "770-955-2226"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "20461501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20461501",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline S. Urtecho, M.D.
• US Medical Staffing
• US Ride Trans LLC
• US Vascular Access Center of Philadelphia, LLC
• US Vascular Access Center of Philadelphia, LLC
• USA DME Medical Supply LLC
• USA DME Supply Inc
• USA Healthcare Services LLC
• USA One Source Solutions LLC
• USA Vein Clinics of Philadelphia LLC

• Ambulatory Surgical Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• 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.