Provider Demographics
NPI:1093028979
Name:BIO-MEDICAL APPLICATIONS OF WISCONSIN INC
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF WISCONSIN INC
Other - Org Name:FRESENIUS MEDICAL CARE SHAWANO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:1509 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-3428
Mailing Address - Country:US
Mailing Address - Phone:715-524-8038
Mailing Address - Fax:715-524-8043
Practice Address - Street 1:1509 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166-3428
Practice Address - Country:US
Practice Address - Phone:715-524-8038
Practice Address - Fax:715-524-8043
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-20
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment