Organization
KIDNEY HOME CENTER, LLC
Active
Other names
Kidney HOME Downtown
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
200 SAINT PAUL ST, STE 5, BALTIMORE, MD 21202-2025
(410) 244-5638
(410) 244-6405
Mailing address
5200 VIRGINIA WAY, L&C DEPT., BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2702
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000466 00
—
MD
01
—
E2702
STATE LICENSE
MD
Enumeration date
06/12/2015
Last updated
03/12/2026
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