Provider Demographics
NPI:1952405722
Name:FRESENIUS ANNE ARUNDEL OUTPATIENT DIALYSIS SERVICES, LLC
Entity Type:Organization
Organization Name:FRESENIUS ANNE ARUNDEL OUTPATIENT DIALYSIS SERVICES, LLC
Other - Org Name:FMCNA DIALYSIS SERVICES OF ANNE ARUNDEL
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 1:2032 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2916
Mailing Address - Country:US
Mailing Address - Phone:410-266-7288
Mailing Address - Fax:410-266-3011
Practice Address - Street 1:2032 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2916
Practice Address - Country:US
Practice Address - Phone:410-266-7288
Practice Address - Fax:410-266-3011
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-12
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD212637Medicare Oscar/Certification