Provider Demographics
NPI:1629493218
Name:BIO-MEDICAL APPLICATIONS OF VIRGINIA, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF VIRGINIA, INC.
Other - Org Name:KEMPSVILLE HOME DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIVITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:6161 KEMPSVILLE CIR STE 155
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3950
Mailing Address - Country:US
Mailing Address - Phone:757-461-9422
Mailing Address - Fax:757-459-8093
Practice Address - Street 1:6161 KEMPSVILLE CIR STE 155
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3950
Practice Address - Country:US
Practice Address - Phone:757-461-9422
Practice Address - Fax:757-459-8093
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-19
Last Update Date:2021-02-18
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