Organization
DVA HEALTHCARE OF MARYLAND LLC
Active
Parent organization
DAVITA INC
Other names
Howard Street Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVITA INC
Authorized official
JOHN D WINSTEL JR. (CHIEF ACCOUNTING OFFICER, TREASURER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
22 S HOWARD ST, BALTIMORE, MD 21201-2505
(410) 539-5015
(410) 539-4771
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4218
(303) 209-7825
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2606
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095514100
—
MD
Enumeration date
03/24/2006
Last updated
04/10/2020
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