Healthcare Provider Details

I. General information

NPI: 1003274309
Provider Name (Legal Business Name): FRESENIUS MEDICAL CARE SANDHILL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2016
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 ENTERPRISE RD
SOCORRO NM
87801-4199
US

IV. Provider business mailing address

1306 ENTERPRISE RD
SOCORRO NM
87801-4199
US

V. Phone/Fax

Practice location:
  • Phone: 575-835-8923
  • Fax: 575-835-2339
Mailing address:
  • Phone: 575-835-8923
  • Fax: 575-835-2339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BARRY L. BLANTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 781-699-9000