Provider Demographics
NPI:1144564857
Name:LIBERTY NEW MEXICO PARTNERS 2, LLC
Entity Type:Organization
Organization Name:LIBERTY NEW MEXICO PARTNERS 2, LLC
Other - Org Name:LIBERTY DIALYSIS - RIO RANCHO
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 1:5751 MCMAHON BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-6370
Mailing Address - Country:US
Mailing Address - Phone:505-899-1019
Mailing Address - Fax:505-899-1205
Practice Address - Street 1:5751 MCMAHON BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-6370
Practice Address - Country:US
Practice Address - Phone:505-899-1019
Practice Address - Fax:505-899-1205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-19
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment