Provider Demographics
NPI:1073625885
Name:BIO-MEDICAL APPLICATIONS OF GEORGIA, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF GEORGIA, INC.
Other - Org Name:FMC DIALYSIS SERVICES WALTON
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 1:299 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-3184
Mailing Address - Country:US
Mailing Address - Phone:770-266-7399
Mailing Address - Fax:770-266-7398
Practice Address - Street 1:299 PLAZA DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-3184
Practice Address - Country:US
Practice Address - Phone:770-266-7399
Practice Address - Fax:770-266-7398
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2023-10-13
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
GA112718Medicare Oscar/Certification