Provider Demographics
NPI:1669717039
Name:FRESENIUS MEDICAL CARE FRESNO, LLC
Entity type:Organization
Organization Name:FRESENIUS MEDICAL CARE FRESNO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position: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 1:6737 N WILLOW AVE
Mailing Address - Street 2:BLDG C
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5954
Mailing Address - Country:US
Mailing Address - Phone:559-324-1070
Mailing Address - Fax:559-324-0704
Practice Address - Street 1:6737 N WILLOW AVE
Practice Address - Street 2:BLDG C
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5954
Practice Address - Country:US
Practice Address - Phone:559-324-1070
Practice Address - Fax:559-324-0704
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment