Provider Demographics
NPI:1093900763
Name:KIDNEY CARE SERVICES, LLC
Entity Type:Organization
Organization Name:KIDNEY CARE SERVICES, LLC
Other - Org Name:KIDNEY CARE SERVICES OF BROOKVILLE
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-371-7590
Mailing Address - Street 1:635 MAPLE AVE
Mailing Address - Street 2:BOX B
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2376
Mailing Address - Country:US
Mailing Address - Phone:814-375-4321
Mailing Address - Fax:814-375-6157
Practice Address - Street 1:477 ROUTE 28
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-7159
Practice Address - Country:US
Practice Address - Phone:814-375-4321
Practice Address - Fax:814-375-6157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment