Provider Demographics
NPI:1821117193
Name:BIO-MEDICAL APPLICATIONS OF PUERTO RICO INC
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF PUERTO RICO INC
Other - Org Name:FRESENIUS MEDICAL CARE SANTA ROSA DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:URB VILLA ROSA I
Mailing Address - Street 2:HOSPITAL SANTA ROSA II LOS VETERANOS AVENUE
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-866-5050
Mailing Address - Fax:787-864-4898
Practice Address - Street 1:URB VILLA ROSA I
Practice Address - Street 2:HOSPITAL SANTA ROSA II LOS VETERANOS AVENUE
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-866-5050
Practice Address - Fax:787-864-4898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-28
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QE0700X
PR14282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
402313Medicare Oscar/Certification