Provider Demographics
NPI:1659470664
Name:BIO-MEDICAL APPLICATIONS OF PUERTO RICO, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF PUERTO RICO, INC.
Other - Org Name:FMC DIALYSIS SERVICES NORTH MAYAGUEZ RENAL CENTER
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:PO BOX 3516
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3516
Mailing Address - Country:US
Mailing Address - Phone:787-834-1550
Mailing Address - Fax:787-834-4544
Practice Address - Street 1:5320 ROAD #64, KM.0.5
Practice Address - Street 2:BO. SABANETAS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00681
Practice Address - Country:US
Practice Address - Phone:787-834-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2023-10-24
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
402525Medicare ID - Type Unspecified