Provider Demographics
NPI:1558705517
Name:BIO-MEDICAL APPLICATIONS OF VIRGINIA, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF VIRGINIA, INC.
Other - Org Name:FRESENIUS MEDICAL CARE LAKE OF THE WOODS
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 1:4122 PARTNERSHIP WAY
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:VA
Mailing Address - Zip Code:22508-5229
Mailing Address - Country:US
Mailing Address - Phone:540-972-2174
Mailing Address - Fax:540-972-2166
Practice Address - Street 1:4122 PARTNERSHIP WAY
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:VA
Practice Address - Zip Code:22508-5229
Practice Address - Country:US
Practice Address - Phone:540-972-2174
Practice Address - Fax:540-972-2166
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-22
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA492673Medicare Oscar/Certification