Healthcare Provider Details

I. General information

NPI: 1932377371
Provider Name (Legal Business Name): FRESENIUS MEDICAL CARE COMPREHENSIVE CKD SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 11/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 SHEARER ST CKD SERVICES OF GREENSBURG
GREENSBURG PA
15601-2746
US

IV. Provider business mailing address

920 WINTER ST FMCNA CKD SERVICES 3W-16
WALTHAM MA
02451-1521
US

V. Phone/Fax

Practice location:
  • Phone: 724-832-8061
  • Fax: 724-832-9311
Mailing address:
  • Phone: 781-699-4160
  • Fax: 781-699-4046

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 State

VIII. Authorized Official

Name: MARK FAWCETT
Title or Position: VICE PRESIDENT, TREASURER
Credential:
Phone: 781-699-2668