Organization
ADVANCED DIALYSIS CENTER, LLC
Active
Parent organization
ADVANCED DIALYSIS CENTER, LLC
Other names
Advanced Dialysis Center Crofton
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED DIALYSIS CENTER, LLC
Authorized official
MARY HAYES JENKINS RN (CEO)
(301) 577-1007
Entity
Organization
Contact information
Practice address
2131 DAVIDSONVILLE RD, CROFTON, MD 21114-1632
(301) 577-1007
Mailing address
9320 ANNAPOLIS RD STE 200, LANHAM, MD 20706-3121
(301) 577-1007
(301) 577-1006
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
—
4220242
—
MD
Enumeration date
01/22/2020
Last updated
01/22/2020
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