Provider Demographics
NPI:1285001594
Name:FRESENIUS MEDICAL CARE BOONE COUNTY, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE BOONE COUNTY, LLC
Other - Org Name:FRESENIUS MEDICAL CARE EDGEWOOD
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 1:210 THOMAS MORE PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3429
Mailing Address - Country:US
Mailing Address - Phone:859-331-0167
Mailing Address - Fax:859-331-1222
Practice Address - Street 1:210 THOMAS MORE PKWY STE 1
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3429
Practice Address - Country:US
Practice Address - Phone:859-331-0167
Practice Address - Fax:859-331-1222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-24
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment