Provider Demographics
NPI:1790137578
Name:FRESENIUS MEDICAL CARE
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAMFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7816-994-3987
Mailing Address - Street 1:920 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1521
Mailing Address - Country:US
Mailing Address - Phone:781-699-9000
Mailing Address - Fax:
Practice Address - Street 1:920 WINTER ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1521
Practice Address - Country:US
Practice Address - Phone:781-699-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization