Organization
KIDNEY HOME CENTER LLC
Active
Other names
KIDNEY HOME CENTER PD
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2270 ROLLING RUN DR STE 600, WINDSOR MILL, MD 21244-1864
(410) 265-0618
(410) 265-0614
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4214
(888) 944-3352
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2659
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4186621 00
—
MD
Enumeration date
09/10/2008
Last updated
08/30/2023
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