FRESENIUS MEDICAL CARE GLENDALE, LLC


Address: 623 S Central Ave, Glendale, CA 91204
Phone: 8055843966

FRESENIUS MEDICAL CARE GLENDALE, LLC (NPI# 1396111886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396111886
Entity Type Organization
Organization Name FRESENIUS MEDICAL CARE GLENDALE, LLC
Other Organization Name FRESENIUS MEDICAL CARE WEST GLENDALE
Practice Address 623 S Central Ave
Glendale
CA 91204
Mailing Address 623 S Central Ave
Glendale
CA 91204-2008
Practice Telephone 8055843966
Practice Fax Number 8055843972
Mailing Telephone 8055843966
Mailing Fax Number 8055843972
Enumeration Date 2015-08-19
Last Update Date 2018-08-09
Authorized Official Name MARK FAWCETT (TREASURER)
Authorized Official Telephone 7816999000
Is Organization Subpart Y
Parent Organization Name FRESENIUS MEDICAL CARE HOLDINGS INC.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QE0700X Clinic/Center
Specialization: End-Stage Renal Disease (ESRD) Treatment
AZ Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA PTAN 552836 01

Other Provider/Organization Names

Other Name Type Code
Fresenius Medical Care West Glendale Doing Business As Name - Organization

Office Location

Street Address 623 S CENTRAL AVE
City GLENDALE
State CA
Zip Code 91204

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Taxonomy Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

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Competitor

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City GLENDALE
Zip Code 91204

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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