Provider Demographics
NPI:1508370404
Name:BIO-MEDICAL APPLICATIONS OF ARIZONA, LLC
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF ARIZONA, LLC
Other - Org Name:FRESENIUS KIDNEY CARE CANYON VISTA
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 1:5555 MESA VERDE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-4311
Mailing Address - Country:US
Mailing Address - Phone:520-458-4490
Mailing Address - Fax:520-458-4977
Practice Address - Street 1:5555 MESA VERDE DR STE 120
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4311
Practice Address - Country:US
Practice Address - Phone:520-458-4490
Practice Address - Fax:520-458-4977
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-30
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