Provider Demographics
NPI:1518171271
Name:READING DIALYSIS CENTER, LLC
Entity Type:Organization
Organization Name:READING DIALYSIS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:FLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-534-5102
Mailing Address - Street 1:PO BOX 536175
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15253-5903
Mailing Address - Country:US
Mailing Address - Phone:610-370-5323
Mailing Address - Fax:610-370-5329
Practice Address - Street 1:965 BERKSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1229
Practice Address - Country:US
Practice Address - Phone:610-370-5323
Practice Address - Fax:610-370-5329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2015-12-21
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
PA1020162360001Medicaid
PA1020162360001Medicaid
PA1020162360001Medicaid