Healthcare Provider Details

I. General information

NPI: 1881522647
Provider Name (Legal Business Name): FRESENIUS MEDICAL CARE NORTHERN LANCASTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 BRIDGEMILL DR.
INDIAN LAND SC
29707
US

IV. Provider business mailing address

2023 BRIDGEMILL DR.
INDIAN LAND SC
29707
US

V. Phone/Fax

Practice location:
  • Phone: 803-650-4494
  • Fax: 803-986-7063
Mailing address:
  • Phone: 803-650-4494
  • Fax: 803-986-7063

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: BARRY BLANTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 781-676-5200