Provider Demographics
NPI:1619031978
Name:NMS DIALYSIS CENTER OF HAGERSTOWN LLC
Entity Type:Organization
Organization Name:NMS DIALYSIS CENTER OF HAGERSTOWN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED PERSON
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:W
Authorized Official - Last Name:NEISWANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-864-2333
Mailing Address - Street 1:14014 MARSH PIKE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-1638
Mailing Address - Country:US
Mailing Address - Phone:301-733-8700
Mailing Address - Fax:301-714-0057
Practice Address - Street 1:14014 MARSH PIKE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-1638
Practice Address - Country:US
Practice Address - Phone:301-733-8700
Practice Address - Fax:301-714-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment