Provider Demographics
NPI:1528213261
Name:FRESENIUS MEDICAL CARE DIABLO NEPHROLOGY CLINICS, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE DIABLO NEPHROLOGY CLINICS, LLC
Other - Org Name:FRESENIUS MEDICAL CARE - DIABLO WEST ANTIOCH
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 1:2386 BUCHANAN RD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4411
Mailing Address - Country:US
Mailing Address - Phone:925-756-2490
Mailing Address - Fax:925-756-2494
Practice Address - Street 1:2386 BUCHANAN RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4411
Practice Address - Country:US
Practice Address - Phone:925-756-2490
Practice Address - Fax:925-756-2494
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-21
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment