Provider Demographics
NPI:1932568037
Name:FRESENIUS MEDICAL CARE INDIANA, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE INDIANA, LLC
Other - Org Name:FRESENIUS MEDICAL CARE INDIANAPOLIS MIDTOWN
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 1:3007 DR ANDREW J BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-4026
Mailing Address - Country:US
Mailing Address - Phone:317-924-8104
Mailing Address - Fax:317-924-8166
Practice Address - Street 1:3007 DR ANDREW J BROWN AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-4026
Practice Address - Country:US
Practice Address - Phone:317-924-8104
Practice Address - Fax:317-924-8166
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-17
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment