Provider Demographics
NPI:1114039948
Name:BIO-MEDICAL APPLICATIONS OF GEORGIA INC
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF GEORGIA INC
Other - Org Name:FRESENIUS MEDICAL CARE MACON DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:280 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-3954
Mailing Address - Country:US
Mailing Address - Phone:478-743-9506
Mailing Address - Fax:478-742-3801
Practice Address - Street 1:280 CLINTON ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3954
Practice Address - Country:US
Practice Address - Phone:478-743-9506
Practice Address - Fax:478-742-3801
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:2011-10-21
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
112516Medicare Oscar/Certification