Provider Demographics
NPI: | 1609160167 |
---|---|
Name: | LDHB, LLC |
Entity Type: | Organization |
Organization Name: | LDHB, LLC |
Other - Org Name: | LDHB LLC |
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: | 500 N 12TH ST STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | LEMOYNE |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 17043-1241 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 717-230-1630 |
Mailing Address - Fax: | 717-230-1635 |
Practice Address - Street 1: | 500 N 12TH ST STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | LEMOYNE |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17043-1241 |
Practice Address - Country: | US |
Practice Address - Phone: | 717-230-1630 |
Practice Address - Fax: | 717-230-1635 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | FRESENIUS MEDICAL CARE HOLDINGS, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2011-06-01 |
Last Update Date: | 2023-10-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QE0700X | Ambulatory Health Care Facilities | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment |