Provider Demographics
NPI:1285697706
Name:DCA OF CARLISLE INC
Entity type:Organization
Organization Name:DCA OF CARLISLE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-213-4700
Mailing Address - Street 1:PO BOX 19119
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-6601
Mailing Address - Country:US
Mailing Address - Phone:870-931-5400
Mailing Address - Fax:870-931-5418
Practice Address - Street 1:101 NOBLE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4100
Practice Address - Country:US
Practice Address - Phone:717-258-3099
Practice Address - Fax:717-258-3632
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U S RENAL CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-07
Last Update Date:2018-06-21
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
PA0016627710001Medicaid
PA1520690OtherGATEWAY
PA392627OtherAUSA LIFE INSURANCE
PA392627OtherCOMBINED INSURANCE
PW392627OtherCAPITAL BLUE CROSS
PA392627OtherCAREFIRST
PA392627OtherFRANK J SIRACUSA
PA392627OtherCORNING HEALTH
PA392627OtherFLEET RESERVE
PA392627OtherCIGNA
PA392627OtherAARP/UNITED HEALTHCARE
PA392627OtherCARPENTERS HEALTH
PA392627OtherAMERICAN MARITIME
PA392627OtherBOARD OF PENSIONS
PA5694652OtherAETNA
PA1662771OtherHEALTHMATE
PA392627OtherADVANTRA
PAPPA01553OtherPA CHRONIC RENAL PROGRAM
PAPPA01553OtherPA CHRONIC RENAL PROGRAM