Organization
KIDNEY HOME CENTER LLC
Active
Other names
Glen Burnie Home Training
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
6934 AVIATION BLVD, STE H, GLEN BURNIE, MD 21061-2593
(410) 760-4976
(410) 761-1040
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4214
(866) 944-3352
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2674
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421454400
—
MD
Enumeration date
11/18/2011
Last updated
04/24/2023
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