Provider Demographics
NPI:1689035693
Name:BALTIMORE COUNTY DIALYSIS, LLC
Entity Type:Organization
Organization Name:BALTIMORE COUNTY DIALYSIS, LLC
Other - Org Name:FRESENIUS KIDNEY CARE CAROLINE STREET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:407 N CAROLINE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-1003
Mailing Address - Country:US
Mailing Address - Phone:410-537-5830
Mailing Address - Fax:410-522-1596
Practice Address - Street 1:407 N CAROLINE ST STE 100
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-1003
Practice Address - Country:US
Practice Address - Phone:410-537-5830
Practice Address - Fax:410-522-1596
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-18
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment