INDEPENDENT DIALYSIS FOUNDATION INC NPI 1316954381

NPI Information

NPI: 1316954381
Provider Name: INDEPENDENT DIALYSIS FOUNDATION, INC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 21D0724874

Address:
901 SETON DR
FLOOR 1
CUMBERLAND, MD
ZIP 21502
Phone: (410) 468-0900
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INDEPENDENT DIALYSIS FOUNDATION, INC is an end-stage renal disease (esrd) treatment clinic center in Cumberland, MD. INDEPENDENT DIALYSIS FOUNDATION, INC NPI is 1316954381. The provider is registered as an organization entity type.

The provider's business location address is:

901 SETON DR
FLOOR 1
CUMBERLAND, MD
ZIP 21502-817
Phone: (410) 468-0900
Fax: (410) 468-0911

The provider's authorized official is Zeke Ayele .
The authorized official title is Director Of Information Systems and has the following contact phone number (410) 468-0900.

The CLIA number assigned to this NPI record is 21D0724874 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/2/2006 and was last updated on 7/16/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	E2617	MARYLAND	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0125608	OTHER	MARYLAND	AETNA
2	618714-01	OTHER	MARYLAND	CAREFIRST
3	0005759000	MEDICAID	WEST VIRGINIA
4	215143	OTHER	MARYLAND	MDIPA
5	21506	OTHER	MARYLAND	JAI MEDICAL
6	212617	MEDICARE ID-TYPE UNSPECIFIED	MARYLAND
7	01689292	MEDICAID	PENNSYLVANIA
8	0704865003	OTHER	MARYLAND	CIGNA
9	PS2	OTHER	MARYLAND	FEP

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: 5/5/2024

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