Provider Demographics
NPI:1255509048
Name:BIO-MEDICAL APPLICATIONS OF PUERTO RICO, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF PUERTO RICO, INC.
Other - Org Name:FMC DIALYSIS SERVICES OF CANOVANAS
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:ROAD #3, KM. 19.9
Mailing Address - Street 2:CANOVANAS WARD
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0000
Mailing Address - Country:US
Mailing Address - Phone:787-957-9647
Mailing Address - Fax:787-256-1010
Practice Address - Street 1:ROAD #3, KM. 19.9
Practice Address - Street 2:CANOVANAS WARD
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-0000
Practice Address - Country:US
Practice Address - Phone:787-957-9647
Practice Address - Fax:787-256-1010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-14
Last Update Date:2023-10-16
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
PR1255509048Medicaid