Provider Demographics
NPI:1427418052
Name:FRESENIUS MEDICAL CARE NAK RADCLIFF, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE NAK RADCLIFF, LLC
Other - Org Name:FRESENIUS MEDICAL CARE NORTH HARDIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:211 E LINCOLN TRAIL BLVD
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-1255
Mailing Address - Country:US
Mailing Address - Phone:270-352-2555
Mailing Address - Fax:270-352-2775
Practice Address - Street 1:211 E LINCOLN TRAIL BLVD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-1255
Practice Address - Country:US
Practice Address - Phone:270-352-2555
Practice Address - Fax:270-352-2775
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-24
Last Update Date:2023-10-19
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
182631Medicare Oscar/Certification