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NPI Code Detail

MEDICARE: FRESENIUS MEDICAL CARE CAPITAL CITY, LLC

MEDICARE: FRESENIUS MEDICAL CARE CAPITAL CITY, 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 : 1114367083
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRESENIUS MEDICAL CARE CAPITAL CITY, LLC
Provider Business Mailing Address
First Line : 2500 COMMERCIAL DR
Second Line :
City : PORT ALLEN
State : LA
Zip : 70767-6145
Country : US
Telephone Number : 225-343-5753
Fax Number : 225-387-0540
Provider Business Practice Location Address
First Line : 2500 COMMERCIAL DR
Second Line :
City : PORT ALLEN
State : LA
Zip : 70767-6145
Country : US
Telephone Number : 225-343-5753
Fax Number : 225-387-0540
Authorized Official
Title or Position : VICE PRESIDENT
Name : BARRY L. BLANTON
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 06/25/2013
Last Update Date : 10/19/2023

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