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FREDERICK KIDNEY CARE ASSOCIATES LLC. NPI 1033305263


NPI Information

NPI: 1033305263
Provider Name: FREDERICK KIDNEY CARE ASSOCIATES LLC.
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

CLIA Number: 21D1074046

Address:
5205 CHAIRMANS CT
SUITE 100
FREDERICK, MD
ZIP 21703
Phone: (301) 696-0012
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FREDERICK KIDNEY CARE ASSOCIATES LLC. is a medical specialty clinic center in Frederick, MD. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). FREDERICK KIDNEY CARE ASSOCIATES LLC. NPI is 1033305263. The provider is registered as an organization entity type.

The provider's business location address is:

5205 CHAIRMANS CT
SUITE 100
FREDERICK, MD
ZIP 21703-915
Phone: (301) 696-0012

The provider's authorized official is Rohan R Rengen .
The authorized official title is Partner and has the following contact phone number (301) 696-0012.

The CLIA number assigned to this NPI record is 21D1074046 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/21/2007 and was last updated on 6/13/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyW12133963MARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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