KIDNEY HOME CENTER LLC (NPI# 1144597196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144597196 |
| Entity Type | Organization |
| Organization Name | KIDNEY HOME CENTER LLC |
| Other Organization Name | GLEN BURNIE HOME TRAINING |
| Practice Address |
6934 Aviation Blvd Ste H Glen Burnie MD 21061-2593 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 4107604976 |
| Practice Fax Number | 4107611040 |
| Mailing Telephone | 6153204214 |
| Mailing Fax Number | 8669443352 |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2019-06-19 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
E2674 | MD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 421454400 | 05 |
| Other Name | Type Code |
|---|---|
| Glen Burnie Home Training | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457500894 | Kidney Home Center LLC | Clinic/Center | 2270 Rolling Run Dr Ste 600, Windsor Mill, MD 21244-1864 | 2008-09-10 |
| Street Address |
6934 AVIATION BLVD STE H |
| City | GLEN BURNIE |
| State | MD |
| Zip Code | 21061-2593 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083614481 | Douglas Mitchell | Hospitalist | 6934 Aviation Blvd, Suite B, Glen Burnie, MD 21061-2593 | 2005-07-28 |
| 1144680281 | Ruth Abigail Bunolna | Nurse Practitioner | 6934 Aviation Blvd, Glen Burnie, MD 21061-2593 | 2016-03-02 |
| 1366815698 | Bridgette Gillin | Nurse Practitioner | 6934 Aviation Blvd, Suite B, Glen Burnie, MD 21061-2593 | 2015-11-09 |
| 1679943583 | Jean Mchale | Social Worker | 6934 Aviation Blvd, Suite N, Glen Burnie, MD 21061-2593 | 2015-10-05 |
| 1053718726 | Julia Brandenburg | Nurse Practitioner | 6934 Aviation Blvd, Suite B, Glen Burnie, MD 21061-2593 | 2014-11-24 |
| 1467858522 | Belinda Williams | Nurse Practitioner | 6934 Aviation Blvd, Suite B, Glen Burnie, MD 21061-2593 | 2014-11-17 |
| 1811313620 | Patrick Desamours | Physician Assistant | 6934 Aviation Blvd, Suite B, Glen Burnie, MD 21061-2593 | 2014-03-17 |
| 1134557366 | Theresa Lohn | Physician Assistant | 6934 Aviation Blvd, Suite B, Glen Burnie, MD 21061-2593 | 2013-10-25 |
| 1326475682 | Michael Hoaglan | Physician Assistant | 6934 Aviation Blvd, Suite B, Glen Burnie, MD 21061-2593 | 2013-10-02 |
| 1972939692 | Tracy Diane Tullier | Physician Assistant | 6934 Aviation Blvd, Suite B, Glen Burnie, MD 21061-2593 | 2013-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255814422 | Lotus Behavioral Health and Rehabilitation Services Inc. | Behavior Technician | 6426 Harrison Square, Glen Burnie, MD 21061 | 2018-09-12 |
| 1942795315 | Tina Brown | Behavior Technician | Rise for Autism, 510 Mccormick Drive, Ste. U-w, Glen Burnie, MD 21061 | 2018-06-27 |
| 1205351905 | Digna Emerita Sanchez De Vasquez | Specialist/Technologist, Other | 201 Fernglen Ave, Glen Burnie, MD 21061 | 2017-08-03 |
| 1255780300 | Rachel Cutts | Physical Therapist | 7711 Quarterfield Rd Ste C2, Glen Burnie, MD 21061 | 2016-06-09 |
| 1295181170 | Gaudenzia, Inc. | Counselor | 5 Crain Highway North - Rear Suite Entrance, Glen Burnie, MD 21061 | 2016-05-10 |
| 1023499548 | Mary Bourbon | Nurse Practitioner | 1600 S. Cain Highway, Suite 401, Glen Burnie, MD 21061 | 2015-06-10 |
| 1972997724 | Robert Oladeinde | Physician Assistant | 6934 Aviation Blvd Suite B, Glen Burnie, MD 21061 | 2015-03-18 |
| 1205248069 | Cathy Qing He | Anesthesiology | 1600 Crain Hwy S Ste 301, Glen Burnie, MD 21061 | 2014-05-28 |
| 1477974764 | Shannon Holder | Nurse Practitioner | 1916 Crain Hwy S Ste 2, Glen Burnie, MD 21061 | 2014-01-03 |
| 1629404207 | Marla Ann Muha | Physician Assistant | 301 Hospital Dr # 803, Glen Burnie, MD 21061 | 2013-09-16 |
| Find all providers in zip 21061 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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|---|---|---|---|---|
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| 1942218797 | Independent Dialysis Foundation, Inc | Clinic/Center | 804 Landmark Dr, Suite 112, Glen Burnie, MD 21061-4486 | 2006-08-04 |
| 1659331254 | Dva Healthcare Renal Care Inc | Clinic/Center | 120 N Langley Rd, Glen Burnie, MD 21060-6578 | 2006-03-27 |
| 1255623534 | Victory Dialysis LLC | Clinic/Center | 6934 Aviation Blvd, Ste J-k-l-m, Glen Burnie, MD 21061-2593 | 2011-05-05 |
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| 1740840503 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 163 Jennifer Rd Ste A, Annapolis, MD 21401-3043 | 2019-06-14 |
| 1538725965 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 3000 N Ridge Rd Ste A, Ellicott City, MD 21043-3311 | 2019-05-10 |
| 1851957286 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 3419 Plumtree Dr Ste 103, Ellicott City, MD 21042-3871 | 2019-05-10 |
| 1144783598 | Fresenius Medical Care Southern Maryland Home, LLC | Clinic/Center | 3510 Old Washington Rd Ste 300, Waldorf, MD 20602-3236 | 2019-04-12 |
| 1205399854 | Mather Dialysis LLC | Clinic/Center | 1840 York Rd Ste A, Lutherville Timonium, MD 21093-5121 | 2019-04-10 |
| 1598228249 | Concerto Maryland LLC | Clinic/Center | 1531 S Edgewood St Ste D, Halethorpe, MD 21227-1138 | 2019-04-10 |
| 1306323050 | Wyota Dialysis, LLC | Clinic/Center | 11700 Livingston Rd, Fort Washington, MD 20744-5150 | 2018-07-25 |
| 1073006276 | Bio Medical Applications of Maryland Inc | Clinic/Center | 28103 Three Notch Rd Ste 1a, Mechanicsville, MD 20659-3294 | 2018-06-12 |
| Find all providers with the same taxonomy | ||||
| City | GLEN BURNIE |
| Zip Code | 21061 |
Please comment or provide details below to improve the information on KIDNEY HOME CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.