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NPI Code Detail

MEDICARE: BIO-MEDICAL APPLICATIONS OF GEORGIA INC

MEDICARE: BIO-MEDICAL APPLICATIONS OF GEORGIA 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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1316086820
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIO-MEDICAL APPLICATIONS OF GEORGIA INC
Provider Business Mailing Address
First Line : 380 SCONYERS STREET
Second Line :
City : METTER
State : GA
Zip : 30439-3338
Country : US
Telephone Number : 912-685-7746
Fax Number : 912-685-4601
Provider Business Practice Location Address
First Line : 380 SCONYERS STREET
Second Line :
City : METTER
State : GA
Zip : 30439-3338
Country : US
Telephone Number : 912-685-7746
Fax Number : 912-685-4601
Authorized Official
Title or Position : TREASURER
Name : MARK FAWCETT
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 02/05/2007
Last Update Date : 08/18/2010

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