Organization
RENAL TREATMENT CENTERS - MID-ATLANTIC, INC.
Active
Other names
Ellicott Kidney Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER, TREASURER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
3000 N RIDGE RD STE A, ELLICOTT CITY, MD 21043-3311
(410) 465-0273
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
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
—
206033700
—
MD
Enumeration date
05/10/2019
Last updated
04/27/2021
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