Provider Demographics
NPI:1205184801
Name:BIO-MEDICAL APPLICATIONS OF NEVADA, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF NEVADA, INC.
Other - Org Name:FRESENIUS MEDICAL CARE LAKE MEADE NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP AND TREASURER
Authorized Official - Prefix:MR
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 1:1905 CIVIC CENTER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-7143
Mailing Address - Country:US
Mailing Address - Phone:702-214-9516
Mailing Address - Fax:702-214-9415
Practice Address - Street 1:1905 CIVIC CENTER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7143
Practice Address - Country:US
Practice Address - Phone:702-214-9516
Practice Address - Fax:702-214-9415
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-29
Last Update Date:2013-09-20
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
NV292519Medicare Oscar/Certification