Provider Demographics
NPI:1871031211
Name:BIO-MEDICAL APPLICATIONS OF MISSISSIPPI, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF MISSISSIPPI, INC.
Other - Org Name:FRESENIUS KIDNEY CARE DERMOTT HOME THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR 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 1:115 E PEDDICORD ST
Mailing Address - Street 2:
Mailing Address - City:DERMOTT
Mailing Address - State:AR
Mailing Address - Zip Code:71638-2314
Mailing Address - Country:US
Mailing Address - Phone:870-538-5228
Mailing Address - Fax:870-538-5228
Practice Address - Street 1:115 E PEDDICORD ST
Practice Address - Street 2:
Practice Address - City:DERMOTT
Practice Address - State:AR
Practice Address - Zip Code:71638-2314
Practice Address - Country:US
Practice Address - Phone:870-538-5228
Practice Address - Fax:870-538-5228
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment