BALTIMORE COUNTY DIALYSIS LLC NPI 1790146702

NPI Information

BALTIMORE COUNTY DIALYSIS, LLC is an end-stage renal disease (esrd) treatment clinic center in Baltimore, MD. BALTIMORE COUNTY DIALYSIS, LLC NPI is 1790146702. The provider is registered as an organization entity type.
The provider Is Doing Business As Fresenius Kidney Care Eastern Avenue.

The provider's business location address is:

4940 EASTERN AVE
5TH FLOOR PAVILION
BALTIMORE, MD
ZIP 21224-735
Phone: (410) 558-5125
Fax: (410) 558-5139

The provider's authorized official is Mark R. Fawcett .
The authorized official title is Sr. Vp And Treasurer and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 21D0974496 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/18/2016 and was last updated on 7/15/2016.

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:

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