Provider Demographics
NPI:1376647149
Name:WARRENTON DIALYSIS FACILITY, INC.
Entity Type:Organization
Organization Name:WARRENTON DIALYSIS FACILITY, INC.
Other - Org Name:BMA WARRENTON
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 1:170 W SHIRLEY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3083
Mailing Address - Country:US
Mailing Address - Phone:540-341-7547
Mailing Address - Fax:540-341-1835
Practice Address - Street 1:170 W SHIRLEY AVE STE 100
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3083
Practice Address - Country:US
Practice Address - Phone:540-341-7547
Practice Address - Fax:540-341-1835
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-12
Last Update Date:2023-10-13
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
492525Medicare ID - Type Unspecified