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NPI Code Detail

MEDICARE: NMS DIALYSIS OF ANNAPOLIS, LLC

MEDICARE: NMS DIALYSIS OF ANNAPOLIS, 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/Center

General Provider Information

NPI Number : 1962776583
Entity Type Code : Organization
Provider Name (Legal Business Name) : NMS DIALYSIS OF ANNAPOLIS, LLC
Provider Business Mailing Address
First Line : 4922 LASALLE RD
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20782-3302
Country : US
Telephone Number : 301-864-2333
Fax Number : 301-864-0443
Provider Business Practice Location Address
First Line : 900 VAN BUREN ST
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21403-2124
Country : US
Telephone Number : 410-267-8653
Fax Number : 410-974-8140
Authorized Official
Title or Position : CHIEF OPERATIONS OFFICER
Name : MR. AGUSTIN RAMOS
Credential :
Telephone Number : 301-864-2333
Provider Enumeration Date : 02/29/2012
Last Update Date : 04/20/2012

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