MEDICARE: FRESENIUS MEDICAL CARE FAIRMOUNT HEIGHTS, LLC

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	:	1710547344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRESENIUS MEDICAL CARE FAIRMOUNT HEIGHTS, LLC

Provider Business Mailing Address
First Line	:	6301 WALKER MILL RD
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-4328
Country	:	US
Telephone Number	:	301-516-4330
Fax Number	:	301-516-4335

Provider Business Practice Location Address
First Line	:	6301 WALKER MILL RD
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-4328
Country	:	US
Telephone Number	:	301-516-4330
Fax Number	:	301-516-4335

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BARRY L. BLANTON
Credential	:
Telephone Number	:	781-699-9000

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	10/20/2023

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