Provider Demographics
NPI:1487818076
Name:BIO-MEDICAL APPLICATIONS OF ARIZONA, LLC
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF ARIZONA, LLC
Other - Org Name:FRESENIUS MEDICAL CARE KINGMAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
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 1:1721 AIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3620
Mailing Address - Country:US
Mailing Address - Phone:928-681-2342
Mailing Address - Fax:928-757-8314
Practice Address - Street 1:1721 AIRWAY AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3620
Practice Address - Country:US
Practice Address - Phone:928-681-2342
Practice Address - Fax:928-757-8314
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-14
Last Update Date:2024-02-28
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
AZ032628Medicare Oscar/Certification