Provider Demographics
NPI:1336526706
Name:NKC BALTIMORE WEST, LLC
Entity Type:Organization
Organization Name:NKC BALTIMORE WEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-687-4883
Mailing Address - Street 1:809 PINNACLE DR
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2535
Mailing Address - Country:US
Mailing Address - Phone:410-864-9800
Mailing Address - Fax:978-450-5289
Practice Address - Street 1:809 PINNACLE DR
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2535
Practice Address - Country:US
Practice Address - Phone:410-864-9800
Practice Address - Fax:978-450-5289
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NXSTAGE KIDNEY CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-05
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment