Provider Demographics
NPI:1083008247
Name:BIO-MEDICAL APPLICATIONS OF ARIZONA, LLC
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF ARIZONA, LLC
Other - Org Name:FRESENIUS MEDICAL CARE OLD TOWN SCOTTSDALE
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 1:4141 N SCOTTSDALE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-4065
Mailing Address - Country:US
Mailing Address - Phone:480-946-1455
Mailing Address - Fax:480-946-0456
Practice Address - Street 1:4141 N SCOTTSDALE RD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-4065
Practice Address - Country:US
Practice Address - Phone:480-946-1455
Practice Address - Fax:480-946-0456
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-26
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ03-2648OtherPTAN