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NPI Code Detail

MEDICARE: FRESENIUS MEDICAL CARE MIDWEST DIALYSIS, LLC

MEDICARE: FRESENIUS MEDICAL CARE MIDWEST DIALYSIS, LLC
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1023354867
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRESENIUS MEDICAL CARE MIDWEST DIALYSIS, LLC
Provider Business Mailing Address
First Line : 3120 S 27TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4338
Country : US
Telephone Number : 414-643-1714
Fax Number : 414-643-5018
Provider Business Practice Location Address
First Line : 3120 S 27TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4338
Country : US
Telephone Number : 414-643-1714
Fax Number : 414-643-5018
Authorized Official
Title or Position : VICE PRESIDENT
Name : BARRY L. BLANTON
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 12/26/2012
Last Update Date : 10/18/2023

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