VICTORY DIALYSIS LLC NPI 1255623534

NPI Information

VICTORY DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Glen Burnie, MD. VICTORY DIALYSIS LLC NPI is 1255623534. The provider is registered as an organization entity type.
The provider Is Doing Business As Aviation Blvd Dialysis.

The provider's business location address is:

6934 AVIATION BLVD
STE K
GLEN BURNIE, MD
ZIP 21061-593
Phone: (410) 553-6951
Fax: (410) 766-0513

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 21D1011194 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/5/2011 and was last updated on 4/3/2023.

Taxonomy Codes

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Other Identifiers

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