Organization
ST. THOMAS MORE DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH NASRAWY (CFO)
(301) 864-2333
Entity
Organization
Contact information
Practice address
4920 LASALLE RD, HYATTSVILLE, MD 20782-3302
(301) 864-2333
(301) 864-1377
Mailing address
4920 LASALLE RD, HYATTSVILLE, MD 20782-3302
(301) 864-2333
(301) 864-1377
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2620
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0375251-00
—
DC
05
—
408428400
—
MD
Enumeration date
04/04/2006
Last updated
02/13/2009
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