Organization
INDEPENDENT DIALYSIS FOUNDATION, INC
Active
Parent organization
INDEPENDENT DIALYSIS FOUNDATION, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENT DIALYSIS FOUNDATION, INC
Authorized official
ZEKE AYELE (DIRECTOR OF INFORMATION SYSTEMS)
(410) 468-0900
Entity
Organization
Contact information
Practice address
840 HOLLINS ST, BALTIMORE, MD 21201-1024
(410) 468-0900
(410) 468-0911
Mailing address
840 HOLLINS ST, BALTIMORE, MD 21201-1024
(410) 468-0900
(410) 468-0911
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2515R
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005759000
—
WV
05
—
01689292
—
PA
01
—
590076-01
CAREFIRST
MD
01
—
PS1
FEP
MD
Enumeration date
08/04/2006
Last updated
07/17/2007
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