| Lorien Dialysis, LLC | |
|
6334 Cedar Ln Columbia MD 21044-3898 | |
| (410) 750-7500 | |
| Not Available |
| Full Name | Lorien Dialysis, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 6334 Cedar Ln, Columbia, Maryland |
| Authorized Official Name and Position | Louis G Grimmel (PRESIDENT) |
| Authorized Official Contact | 4107507500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lorien Dialysis, LLC 3300 N Ridge Rd Ste 390 Ellicott City MD 21043-3394 | Lorien Dialysis, LLC 6334 Cedar Ln Columbia MD 21044-3898 Ph: (410) 750-7500 |
| NPI Number | 1013471416 |
|---|---|
| Provider Enumeration Date | 01/30/2019 |
| Last Update Date | 04/12/2021 |
| Certification Date | 04/12/2021 |
| Medicare PECOS PAC ID | 1850728585 |
|---|---|
| Medicare Enrollment ID | O20200219000565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013471416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Secondary |
| 261QE0700X | Clinic/center - End-stage Renal Disease (esrd) Treatment | () | Primary |
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