Renal Life Link Inc
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Childs, PA
NPI 1972565034 · NPPES record last updated May 15, 2020
Key facts
- NPI
- 1972565034
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- RENAL LIFE LINK INC
- Practice address
- 101 Main St
Childs, PA 18407-2905 - Phone
- (570) 281-9201
- Fax
- (570) 281-9185
- NPI assigned
- Apr 4, 2006
- Organization subpart
- No
Authorized official
- Name
- John D Winstel
- Title
- Chief Accounting Officer
- Phone
- (253) 733-4501
National Provider Directory
Locations
101 Main St
Childs, PA 18407
Phone (272) 293-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
101 Main St
Childs, PA 18407-2905
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 341-6410
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1014890420003 | Medicaid | PA |
Other names
- Childs Dialysis
Other providers in Childs, PA
All providers in Childs, PA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.