Provider Demographics
NPI:1467808030
Name:FREEDOM CENTER OF WESTMERE, LLC
Entity Type:Organization
Organization Name:FREEDOM CENTER OF WESTMERE, LLC
Other - Org Name:FREEDOM CENTER OF WESTMERE
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 1:178 WASHINGTON AVENUE EXT
Mailing Address - Street 2:STE 3
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5304
Mailing Address - Country:US
Mailing Address - Phone:518-407-0505
Mailing Address - Fax:518-407-0551
Practice Address - Street 1:178 WASHINGTON AVENUE EXT
Practice Address - Street 2:STE 3
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5304
Practice Address - Country:US
Practice Address - Phone:518-407-0505
Practice Address - Fax:518-407-0551
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-12
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