Organization
HARRIMAN DIALYSIS LLC
Active
Other names
Friendly Farms Home Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
10905 FORT WASHINGTON RD, STE 307, FORT WASHINGTON, MD 20744-5843
(301) 292-0540
(301) 292-3493
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, 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
E2714
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000989 00
—
MD
01
—
E2714
STATE LICENSE
MD
Enumeration date
10/02/2014
Last updated
03/03/2021
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