Basic Information
Provider Information
NPI: 1710428263
EntityType: 2
ReplacementNPI:  
OrganizationName: USRC VOORHEES, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: U.S. RENAL CARE VOORHEES DIALYSIS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5851 LEGACY CIR
Address2: STE 900
City: PLANO
State: TX
PostalCode: 750245966
CountryCode: US
TelephoneNumber: 2147362700
FaxNumber: 2147362790
Practice Location
Address1: 1000 HADDONFIELD BERLIN RD STE 100
Address2:  
City: VOORHEES
State: NJ
PostalCode: 080433520
CountryCode: US
TelephoneNumber: 8565459010
FaxNumber: 8565459011
Other Information
ProviderEnumerationDate: 03/16/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WEINBERG
AuthorizedOfficialFirstName: THOMAS
AuthorizedOfficialMiddleName: L
AuthorizedOfficialTitleorPosition: AUTHORIZED OFFICIAL
AuthorizedOfficialTelephone: 2147362700
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: U.S. RENAL CARE, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QE0700X  Y Ambulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment

No ID Information.


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