Provider Demographics
NPI:1720347883
Name:FRESENIUS MEDICAL CARE TAYLOR
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE TAYLOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-207-3674
Mailing Address - Street 1:22970 NORTHLINE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-4696
Mailing Address - Country:US
Mailing Address - Phone:734-287-6585
Mailing Address - Fax:
Practice Address - Street 1:22970 NORTHLINE RD STE 100
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-4696
Practice Address - Country:US
Practice Address - Phone:734-287-6585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1861475451261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1861475451OtherNPI - ESRD
MI23-2619OtherMEDICARE - ESRD
MI23D1083618OtherCLIA