MEDICARE: BIO-MEDICAL APPLICATIONS OF MICHIGAN, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1093753568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIO-MEDICAL APPLICATIONS OF MICHIGAN, INC.

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

Provider Business Practice Location Address
First Line	:	4800 MCLEOD DR E
Second Line	:	BAY AREA REG. DIALYSIS CTR SAGINAW - CKD SERVICES
City	:	SAGINAW
State	:	MI
Zip	:	48604-2839
Country	:	US
Telephone Number	:	989-790-9440
Fax Number	:	989-790-1335

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. MARK FAWCETT
Credential	:
Telephone Number	:	781-699-2668

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	05/28/2008

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1710095633 — BIO-MEDICAL APPLICATIONS OF MICHIGAN, INC.
Practice Location Address:

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Practice Phone: 989-790-9440
Practice Fax: 989-790-1335

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