Provider Demographics
NPI:1508315656
Name:FRESENIUS MEDICAL CARE RENNER ROAD, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE RENNER ROAD, LLC
Other - Org Name:FRESENIUS KIDNEY CARE RENNER ROAD
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 1:3517 SPECTRUM BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-9703
Mailing Address - Country:US
Mailing Address - Phone:972-234-4326
Mailing Address - Fax:972-234-4336
Practice Address - Street 1:3517 SPECTRUM BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-9703
Practice Address - Country:US
Practice Address - Phone:972-234-4326
Practice Address - Fax:972-234-4336
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-30
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment