Provider Demographics
NPI:1588005300
Name:BIO-MEDICAL APPLICATIONS OF MINNESOTA, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF MINNESOTA, INC.
Other - Org Name:FRESENIUS MEDICAL CARE ROUND LAKE DIALYSIS
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 1:3777 COON RAPIDS BLVD NW STE 120
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2630
Mailing Address - Country:US
Mailing Address - Phone:763-323-1234
Mailing Address - Fax:763-323-6695
Practice Address - Street 1:3777 COON RAPIDS BLVD NW STE 120
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2630
Practice Address - Country:US
Practice Address - Phone:763-323-1234
Practice Address - Fax:763-323-6695
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-09
Last Update Date:2021-08-20
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
MN242590Medicare Oscar/Certification