Dva Healthcare Of Maryland Llc, NPI 1023077328
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Baltimore, MD, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1023077328
NPI Entity Type Organization
Provider Name Dva Healthcare Of Maryland Llc
Doing Business As
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 920 E 25th St, Baltimore, MD, US
Provider Mailing Address 5200 Virginia Way, L&c Dept, Brentwood, TN, US, 370277569
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name John Winstel
Official Position CHIEF ACCOUNTING OFFICER
Phone 253-733-4501

Primary Taxonomy

Taxonomy Code

261QE0700X

Taxonomy Name End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Classification

Clinic/Center

Group

Ambulatory Health Care Facilities

License No. E2595
License State MD
Description Definition to come...

Other Organization Name

25th Street Dialysis
Doing Business As

Business Address

Dva Healthcare Of Maryland Llc
920 E 25th St

Baltimore, MD, US

Phone: 410-235-1611
Fax: 410-235-3721

Mailing Address

Dva Healthcare Of Maryland Llc
5200 Virginia Way
L&c Dept
Brentwood, TN, US
ZIP 370277569
Phone: 615-320-4214
Fax: 866-944-3352

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
1007727620014 PA MEDICAID 05
326000300 MD MEDICAID 05

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DR. DNP CRNA Kelsea Jo Lucas

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Certified Registered Nurse Anesthetist

22 S Greene St

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