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NPI Code Detail

MEDICARE: ABERDEEN DIALYSIS LLC

MEDICARE: ABERDEEN DIALYSIS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/CenterE2650MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326149766
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABERDEEN DIALYSIS LLC
Provider Business Mailing Address
First Line : 5200 VIRGINIA WAY
Second Line : L&C DEPT
City : BRENTWOOD
State : TN
Zip : 37027-7569
Country : US
Telephone Number : 615-320-4214
Fax Number : 866-944-3352
Provider Business Practice Location Address
First Line : 780 W BEL AIR AVE
Second Line :
City : ABERDEEN
State : MD
Zip : 21001-2236
Country : US
Telephone Number : 410-273-9333
Fax Number : 410-273-9337
Authorized Official
Title or Position : CHIEF ACCOUNTING OFFICER
Name : JOHN D WINSTEL
Credential :
Telephone Number : 253-733-4501
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/11/2022

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