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General NPI Number Information
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NPI Number | 1396690939
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Entity Type | Organization
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Legal Business Name | FRESENIUS MEDICAL CARE CENTRACARE DIALYSIS, LLC
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 1111 2ND STREET SOUTH
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City | WAITE PARK
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State | MN
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Zip | 56387-2323
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Country | US
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Telephone | 320-460-6240
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Fax | 320-242-4468
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Provider Business Mailing Address
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Address Line | 1111 2ND STREET SOUTH
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City | WAITE PARK
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State | MN
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Zip | 56387-2323
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Country | US
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Telephone | 320-460-6240
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Fax | 320-242-4468
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | BARRY BLANTON
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Credential |
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Telephone | 781-676-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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