Organization
WHOLE NUTRITION SERVICES
Active
Other names
Whole Nutrition Services, Inc.dba Renal Nutrition Services, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON GREEN RD, CDE, CSR, LDN (OWNER)
(410) 877-6077
Entity
Organization
Contact information
Practice address
1011 INGLESIDE AVE, CATONSVILLE, MD 21228-1318
(410) 877-6077
(410) 877-6087
Mailing address
51 HORSEMAN CT, RANDALLSTOWN, MD 21133-4065
(410) 877-6077
(410) 877-6087
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D01526
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KBV8RE
CAREFIRST BLUE CROSS BLUE SHIELD
MD
Enumeration date
04/16/2009
Last updated
08/13/2012
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