Organization
RENAL TREATMENT CENTERS - MID-ATLANTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
14631 LAUREL BOWIE ROAD, UNITS 100 - 105, LAUREL, MD 20707-4403
(301) 725-3559
(301) 725-3599
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2538
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405359100
—
MD
Enumeration date
03/24/2006
Last updated
08/21/2024
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