Provider Demographics
NPI:1033172556
Name:DCA OF CHAMBERSBURG, INC.
Entity Type:Organization
Organization Name:DCA OF CHAMBERSBURG, INC.
Other - Org Name:U S RENAL CARE CHAMBERSBURG DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT & SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2700
Mailing Address - Street 1:PO BOX 19119
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-6601
Mailing Address - Country:US
Mailing Address - Phone:870-931-5400
Mailing Address - Fax:870-931-5418
Practice Address - Street 1:765 5TH AVE
Practice Address - Street 2:FIFTH AVE PROFESSIONAL CENTER
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4228
Practice Address - Country:US
Practice Address - Phone:717-263-9300
Practice Address - Fax:717-263-7879
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U S RENAL CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-07
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01741721OtherHEALTHMATE
PA34493OtherHEALTH PARTNERS
PA1265899OtherGETTYSBURG HEALTH ADMIN
PA265899OtherMAMSI ALLIANCE
PA1850OtherPA HIGHMARK
PA2125722OtherAETNA
PA1527304OtherGATEWAY MEDICARE ASSURED
PAPPA01555OtherPA CHRONIC RENAL PROGRAM
PA0017417210001Medicaid
PA01741721OtherGATEWAY
PA1850OtherPA HIGHMARK
PA1527304OtherGATEWAY MEDICARE ASSURED