Provider Demographics
NPI:1770036469
Name:BIO-MEDICAL APPLICATIONS OF MISSISSIPPI, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF MISSISSIPPI, INC.
Other - Org Name:FRESENIUS MEDICAL CARE - WEST HINDS COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP AND TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:105 JOHNSTON PL
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5911
Mailing Address - Country:US
Mailing Address - Phone:601-925-9296
Mailing Address - Fax:601-925-9297
Practice Address - Street 1:105 JOHNSTON PL
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5911
Practice Address - Country:US
Practice Address - Phone:601-925-9296
Practice Address - Fax:601-925-9297
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-28
Last Update Date:2017-05-02
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
252585Medicare Oscar/Certification