Provider Demographics
NPI:1689748790
Name:GAREY DIALYSIS CENTER PARTNERSHIP
Entity Type:Organization
Organization Name:GAREY DIALYSIS CENTER PARTNERSHIP
Other - Org Name:RAI - NORTH GAREY - POMONA
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 1:150 E ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2104
Mailing Address - Country:US
Mailing Address - Phone:909-593-5863
Mailing Address - Fax:909-596-2480
Practice Address - Street 1:150 E ARROW HWY
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2104
Practice Address - Country:US
Practice Address - Phone:909-593-5863
Practice Address - Fax:909-596-2480
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2023-10-17
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
CACDC02654FMedicaid
CA052654OtherBLUE CROSS OF CALIFORNIA
CAZZZR0192ZOtherBLUE SHIELD OF CALIFORNIA
CAZZZR0192ZOtherBLUE SHIELD OF CALIFORNIA