MEDICARE: DIALYSIS ACCESS SERVICES, 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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1356890172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIALYSIS ACCESS SERVICES, LLC

Provider Business Mailing Address
First Line	:	1589 SULPHUR SPRING RD
Second Line	:	SUITE 109
City	:	BALTIMORE
State	:	MD
Zip	:	21227-2542
Country	:	US
Telephone Number	:	410-536-5400
Fax Number	:	410-737-2168

Provider Business Practice Location Address
First Line	:	1666 SULPHUR SPRING RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21227-2539
Country	:	US
Telephone Number	:	410-242-0029
Fax Number	:	410-242-0096

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	ROBERT FULD
Credential	:	MD
Telephone Number	:	410-536-5400

Provider Enumeration Date	:	09/22/2016
Last Update Date	:	02/12/2026

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Directions to “DIALYSIS ACCESS SERVICES, LLC ” Practice Location

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