Organization
INDEPENDENT DIALYSIS FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZEKE AYELE (DIRECTOR OF IT)
(410) 468-0900
Entity
Organization
Contact information
Practice address
888 MEMORIAL DR, OAKLAND, MD 21550-5101
(410) 468-0900
Mailing address
840 HOLLINS ST, BALTIMORE, MD 21201-1024
(410) 468-0900
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
01
—
0125608
AETNA
MD
01
—
0704865003
CIGNA
MD
01
—
215143
UNITED HEALTHCARE
MD
05
—
3810011315
—
WV
01
—
916856-01
CAREFIRST BLUE CROSS
MD
01
—
AC2
FEP
MD
Enumeration date
08/11/2006
Last updated
09/09/2014
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