RENAL TREATMENT CENTERS MID ATLANTIC INC NPI 1104886993

NPI Information

RENAL TREATMENT CENTERS MID ATLANTIC INC is an end-stage renal disease (esrd) treatment clinic center in Upper Marlboro, MD. RENAL TREATMENT CENTERS MID ATLANTIC INC NPI is 1104886993. The provider is registered as an organization entity type.
The provider Is Doing Business As Kidney Care Of Largo.

The provider's business location address is:

1300 MERCANTILE LN
STE 194
UPPER MARLBORO, MD
ZIP 20774-339
Phone: (301) 925-4100
Fax: (301) 925-4810

The provider's authorized official is John D Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 21D1020736 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/24/2006 and was last updated on 4/15/2020.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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