Renal Treatment Centers Mid Atlantic Inc.

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

RENAL TREATMENT CENTERS MID ATLANTIC INC.

Doing business as

Golden Mile Dialysis

Practice address

1306 W Patrick St Ste 5
Frederick, MD 21703-4869

Phone

(301) 696-1090

Fax

(301) 696-1095

NPI assigned

May 22, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John D Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Golden Mile Dialysis Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1396236626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4214",
            "fax_number": "866-944-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 W PATRICK ST STE 5",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217034869",
            "telephone_number": "301-696-1090",
            "fax_number": "301-696-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS MID ATLANTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-22",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502231200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Mile Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles A Reisdorf Jr., LCSW-C
• Deborah Rejent, PHD, MSSW, LCSW-C
• Rejuvenate You Counseling, LLC
• Krupa Relan, OT
• Reliable Wound Ostomy Consultant LLC
• Melissa M Rendlen, D.O.
• Connor Raymond Renehan, BEHAVIOR TECHNICIAN
• Rengen Nephrology LLC
• Rohan Raju Rengen, D.O.
• Suneeta Dhupar Rengen, PA-C

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Frederick, MD
• Providers in Frederick, MD by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.