Provider Demographics
NPI:1851495626
Name:RENAL INSTITUTE OF CENTRAL JERSEY, LLC
Entity Type:Organization
Organization Name:RENAL INSTITUTE OF CENTRAL JERSEY, LLC
Other - Org Name:FMC-JOHN J. DEPALMA RENAL CENTER
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 1:2A PLAZA DR UNIT A1
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08757-3756
Mailing Address - Country:US
Mailing Address - Phone:732-505-0637
Mailing Address - Fax:732-505-8399
Practice Address - Street 1:2A PLAZA DR UNIT A1
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-3756
Practice Address - Country:US
Practice Address - Phone:732-505-0637
Practice Address - Fax:732-505-8399
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-12
Last Update Date:2023-10-16
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
312509Medicare Oscar/Certification