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1629044896

NPI Code Detail

MEDICARE: RENAL TREATMENT CENTERS MID ATLANTIC INC

MEDICARE: RENAL TREATMENT CENTERS MID ATLANTIC INC

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	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1629044896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAL TREATMENT CENTERS MID ATLANTIC INC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L & C DEPARTMENT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 NANNIE HELEN BURROUGHS AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-5506
Country	:	US
Telephone Number	:	202-399-7700
Fax Number	:	202-399-3708

Authorized Official
Title or Position	:	VP, LICENSURE & CERTIFICATION
Name	:	SAMUEL T WEY
Credential	:
Telephone Number	:	615-341-6641

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	07/17/2025

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Directions to “RENAL TREATMENT CENTERS MID ATLANTIC INC ” Practice Location

Language	Start Address	Practice Location

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