Provider Demographics
NPI:1912762360
Name:FRESENIUS MEDICAL CARE BRICK HOME THERAPY, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE BRICK HOME THERAPY, LLC
Other - Org Name:FRESENIUS KIDNEY CARE BRICK TOWNSHIP
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 1:1541 ROUTE 88 STE C
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-2373
Mailing Address - Country:US
Mailing Address - Phone:732-965-0501
Mailing Address - Fax:
Practice Address - Street 1:1541 ROUTE 88 STE C
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-2373
Practice Address - Country:US
Practice Address - Phone:732-965-0501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-15
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment