MEDICARE: BIO-MEDICAL APPLICATIONS OF TENNESSEE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center		TN

General Provider Information

NPI Number	:	1003207275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIO-MEDICAL APPLICATIONS OF TENNESSEE, INC.

Provider Business Mailing Address
First Line	:	1 MEDICAL PARK BLVD STE 100E
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-7450
Country	:	US
Telephone Number	:	423-652-0158
Fax Number	:	423-652-0335

Provider Business Practice Location Address
First Line	:	1 MEDICAL PARK BLVD STE 100E
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-7450
Country	:	US
Telephone Number	:	423-652-0158
Fax Number	:	423-652-0335

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BARRY L. BLANTON
Credential	:
Telephone Number	:	781-699-9000

Provider Enumeration Date	:	02/10/2015
Last Update Date	:	10/19/2023

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