Provider Demographics
NPI:1578293403
Name:FRESENIUS MEDICAL CARE CLEBURNE, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE CLEBURNE, LLC
Other - Org Name:CLEBURNE DIALYSIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:160 JACK BURTON DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-7711
Mailing Address - Country:US
Mailing Address - Phone:817-558-1593
Mailing Address - Fax:817-558-1504
Practice Address - Street 1:160 JACK BURTON DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76031-7711
Practice Address - Country:US
Practice Address - Phone:817-558-1593
Practice Address - Fax:817-558-1504
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-14
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