1932377371 NPI number — FRESENIUS MEDICAL CARE COMPREHENSIVE CKD SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932377371 NPI number — FRESENIUS MEDICAL CARE COMPREHENSIVE CKD SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRESENIUS MEDICAL CARE COMPREHENSIVE CKD SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CKD SERVICES OF GREENSBURG
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932377371
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
920 WINTER ST
Provider Second Line Business Mailing Address:
FMCNA CKD SERVICES 3W-16
Provider Business Mailing Address City Name:
WALTHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02451-1521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-699-4160
Provider Business Mailing Address Fax Number:
781-699-4046

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
562 SHEARER ST
Provider Second Line Business Practice Location Address:
CKD SERVICES OF GREENSBURG
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-2746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-832-8061
Provider Business Practice Location Address Fax Number:
724-832-9311
Provider Enumeration Date:
02/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
FAWCETT
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT, TREASURER
Authorized Official Telephone Number:
781-699-2668

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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