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Organization

RAI CARE CENTERS OF MARYLAND I, LLC

Active
Other names
RAI-Silver Hill-District Heights
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JON M SUNDOCK (VICE PRESIDENT)
(615) 507-3307
Entity
Organization

Contact information

Practice address
5652 SILVER HILL ROAD, DISTRICT HEIGHTS, MD 20747-1145
(301) 967-9891
(301) 967-6964
Mailing address
1550 W. MCEWEN DRIVE, SUITE 500, FRANKLIN, TN 37067-1731
(615) 661-1100
(615) 507-3300

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
037702500
DC
01
184625
ANTHEM VA BCBS
VA
05
409585501
MD
01
88170801
CAREFIRST BCBS
MD
Enumeration date
10/02/2006
Last updated
02/15/2011
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