Healthcare Provider Details

I. General information

NPI: 1720347883
Provider Name (Legal Business Name): FRESENIUS MEDICAL CARE TAYLOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 05/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22970 NORTHLINE RD STE 100
TAYLOR MI
48180-4696
US

IV. Provider business mailing address

22970 NORTHLINE RD STE 100
TAYLOR MI
48180-4696
US

V. Phone/Fax

Practice location:
  • Phone: 734-287-6585
  • Fax:
Mailing address:
  • Phone: 734-287-6585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number1861475451
License Number StateMI

VIII. Authorized Official

Name: MR. STEVEN CHOWEN
Title or Position: REGIONAL VICE PRESIDENT
Credential:
Phone: 734-207-3674