Provider Demographics
NPI:1013022862
Name:OHIO RENAL CARE GROUP, LLC
Entity Type:Organization
Organization Name:OHIO RENAL CARE GROUP, LLC
Other - Org Name:OHIO RENAL CARE GROUP WEST
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 1:14670 SNOW RD
Mailing Address - Street 2:
Mailing Address - City:BROOKPARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142-2461
Mailing Address - Country:US
Mailing Address - Phone:216-267-1451
Mailing Address - Fax:216-267-2241
Practice Address - Street 1:14670 SNOW RD
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-2461
Practice Address - Country:US
Practice Address - Phone:216-267-1451
Practice Address - Fax:216-267-2241
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-20
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
362568Medicare ID - Type Unspecified