Provider Demographics
NPI:1821581455
Name:FRESENIUS MEDICAL CARE JERSEY CITY, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE JERSEY CITY, LLC
Other - Org Name:BIO-MEDICAL APPLICATIONS OF JERSEY CITY
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 1:107 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-3217
Mailing Address - Country:US
Mailing Address - Phone:201-451-3760
Mailing Address - Fax:201-451-2863
Practice Address - Street 1:107 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-3217
Practice Address - Country:US
Practice Address - Phone:201-451-3760
Practice Address - Fax:201-451-2863
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-08
Last Update Date:2023-11-17
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
NJ0679194Medicaid