Organization
PARKSIDE DIALYSIS LLC
Active
Other names
Pikesville Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
6609 REISTERSTOWN RD, STE 100, BALTIMORE, MD 21215-2662
(410) 358-1745
(410) 358-1526
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
E2636
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423025600
—
MD
01
—
E2636
STATE LICENSE
MD
Enumeration date
02/10/2014
Last updated
12/23/2025
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