Healthcare Provider Details
I. General information
NPI: 1518488428
Provider Name (Legal Business Name): BIO-MEDICAL APPLICATIONS OF DELAWARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2017
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1417 FOULK RD STE 100
TALLEYVILLE DE
19803-2727
US
IV. Provider business mailing address
1417 FOULK RD STE 100
TALLEYVILLE DE
19803-2727
US
V. Phone/Fax
- Phone: 302-479-7130
- Fax: 302-479-7132
- Phone: 302-479-7130
- Fax: 302-479-7132
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BARRY
L.
BLANTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 781-699-9000