Organization
AHERN DIALYSIS LLC
Active
Other names
Odenton Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
1360 BLAIR DR, SUITE L & M, ODENTON, MD 21113-1343
(410) 674-3918
(410) 672-8947
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4214
(866) 944-3352
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2711
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4244176 00
—
MD
01
—
E2711
STATE LICENSE
MD
Enumeration date
07/14/2015
Last updated
05/28/2021
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