Provider Demographics
NPI:1598134611
Name:DREXEL UNIVERSITY
Entity Type:Organization
Organization Name:DREXEL UNIVERSITY
Other - Org Name:DREXEL RENAL DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BILLING OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MELADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-255-7788
Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1320
Mailing Address - Country:US
Mailing Address - Phone:215-255-7822
Mailing Address - Fax:215-255-7825
Practice Address - Street 1:230 N BROAD ST
Practice Address - Street 2:18TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1121
Practice Address - Country:US
Practice Address - Phone:215-762-7038
Practice Address - Fax:215-762-7015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment