AHERN DIALYSIS LLC NPI 1699159228

NPI Information

NPI: 1699159228
Provider Name: AHERN DIALYSIS LLC
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
Doing Business As: ODENTON DIALYSIS
CLIA Number: 21D2105353
Address: 1360 BLAIR DR
SUITE L & M
ODENTON, MD
ZIP 21113
Phone: (410) 674-3918

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NPI Details

AHERN DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Odenton, MD. AHERN DIALYSIS LLC NPI is 1699159228. The provider is registered as an organization entity type.
The provider Is Doing Business As Odenton Dialysis.

The provider's business location address is:

1360 BLAIR DR
SUITE L & M
ODENTON, MD
ZIP 21113-343
Phone: (410) 674-3918
Fax: (410) 672-8947

The provider's authorized official is John 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 21D2105353 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2015 and was last updated on 5/28/2021.

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	E2711	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	4244176 00	MEDICAID	MARYLAND
2	E2711	OTHER	MARYLAND	STATE LICENSE

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: 11/21/2025

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