Provider Demographics
NPI:1619994332
Name:BIO-MEDICAL APPLICATIONS OF SOUTH CAROLINA, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF SOUTH CAROLINA, INC.
Other - Org Name:ANDERSON DIALYSIS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:416 E CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5800
Mailing Address - Country:US
Mailing Address - Phone:864-224-1678
Mailing Address - Fax:864-224-2830
Practice Address - Street 1:416 E CALHOUN ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5800
Practice Address - Country:US
Practice Address - Phone:864-224-1678
Practice Address - Fax:864-224-2830
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCERD-105261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC422506Medicaid
SC422506Medicaid