Provider Demographics
NPI:1164564373
Name:CARBON MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:CARBON MEDICAL ASSOCIATES
Other - Org Name:CARBON NEPHROLOGY ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:BOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-824-3752
Mailing Address - Street 1:218 DELAWARE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALMERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18071-1858
Mailing Address - Country:US
Mailing Address - Phone:610-826-6353
Mailing Address - Fax:610-826-6359
Practice Address - Street 1:218 DELAWARE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PALMERTON
Practice Address - State:PA
Practice Address - Zip Code:18071-1858
Practice Address - Country:US
Practice Address - Phone:610-826-6353
Practice Address - Fax:610-826-6359
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARBON MEDICAL ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-13
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty