St. Thomas More Dialysis Center LLC

Primary specialty

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

License

E2620 Issued in MD

Legal business name

ST. THOMAS MORE DIALYSIS CENTER LLC

Practice address

4920 Lasalle Rd
Hyattsville, MD 20782-3302

Phone

(301) 864-2333

Fax

(301) 864-1377

NPI assigned

Apr 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Nasrawy

Title

Cfo

Phone

(301) 864-2333

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234483200000",
    "number": "1982666087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 LASALLE RD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823302",
            "telephone_number": "301-864-2333",
            "fax_number": "301-864-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 LASALLE RD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823302",
            "telephone_number": "301-864-2333",
            "fax_number": "301-864-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. THOMAS MORE DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2009-02-13",
        "status": "A",
        "authorized_official_last_name": "NASRAWY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-864-2333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MD",
            "license": "E2620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0375251-00",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408428400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sowbah Healthcare Services LLC
• Humphrey Sowho
• Sparkle Healing LLC
• Barbara D Spencer
• St Jerome Counseling
• St.Jerome Catholic Church
• Ian Staggers
• Thomas Stallard, M.D.
• Stanly
• Starlite Care Services, Inc.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hyattsville, MD
• Providers in Hyattsville, 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 Feb 13, 2009; 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.