Provider Demographics
NPI:1518983592
Name:BIO-MEDICAL APPLICATIONS OF MAINE, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF MAINE, INC.
Other - Org Name:ANDROSCOGGIN KIDNEY CENTER
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 1:1100 MINOT AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-3739
Mailing Address - Country:US
Mailing Address - Phone:207-795-1315
Mailing Address - Fax:207-795-6033
Practice Address - Street 1:1100 MINOT AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-3739
Practice Address - Country:US
Practice Address - Phone:207-795-1315
Practice Address - Fax:207-795-6033
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-14
Last Update Date:2023-10-13
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
ME999020364Medicaid