BLAUVELT DIALYSIS LLC (NPI# 1891204558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891204558 |
| Entity Type | Organization |
| Organization Name | BLAUVELT DIALYSIS LLC |
| Other Organization Name | COLMARE DIALYSIS |
| Practice Address |
6302 Dixie Hwy Bridgeport MI 48722-9566 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9897770780 |
| Practice Fax Number | 9897770717 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665949961 |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2020-07-23 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1891204558 | 05 |
| Other Name | Type Code |
|---|---|
| Colmare Dialysis | Doing Business As Name - Organization |
| Street Address |
6302 DIXIE HWY |
| City | BRIDGEPORT |
| State | MI |
| Zip Code | 48722-9566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584305 | Ryan Abraham Labean | Behavior Technician | 6296 Village Square Drive, Suite 2, Bridgeport, MI 48722 | 2020-10-06 |
| 1760787360 | Melinda Eve Bierlein | Physical Therapist | 5460 W. Rolling Hills Drive, Bridgeport, MI 48722 | 2011-01-13 |
| 1376016261 | Guidepost Counseling Services, Pllc | Counselor | 7274 Dixie Hwy, Bridgeport, MI 48722 | 2019-01-03 |
| 1497098594 | Nicole Marie Judson | Physical Therapist | 5460 W Rolling Hills Dr, Bridgeport, MI 48722 | 2013-03-27 |
| 1659600377 | Kevin J Luptowski | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722 | 2009-12-08 |
| 1255472114 | Boettcher Home Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 6230 Dixie Hwy, Bridgeport, MI 48722-9513 | 2007-02-12 |
| 1356308480 | Bridgeport Pharmacy, Inc | Durable Medical Equipment & Medical Supplies | 6226 Dixie Hwy, Bridgeport, MI 48722-9513 | 2006-05-01 |
| 1114917242 | Bridgeport Pharmacy Inc | Pharmacist | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2005-10-28 |
| 1922581131 | Midmichigan Rx Services LLC | Pharmacy | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2018-09-13 |
| 1184120990 | Hemang Vinodchandra Patel | Pharmacist | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2018-04-02 |
| Find all providers in zip 48722 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346400629 | Bio Medical Applications of Michigan Inc | Clinic/Center | 5414 W Rolling Hills Dr, Bridgeport, MI 48722-9668 | 2008-06-11 |
| 1104938927 | Bio-medical Applications of West Virginia Inc | Clinic/Center | 16 Sterling Dr., Bridgeport, WV 26330-9107 | 2006-08-31 |
| 1205396744 | Isd Renal Inc | Clinic/Center | 703 Main St, Bridgeport, OH 43912-1315 | 2019-03-21 |
| 1649671439 | Dialyze Direct Ct LLC | Clinic/Center | 600 Bond St, Bridgeport, CT 06610-2205 | 2014-09-11 |
| 1538436753 | Gentle Dialysis Center LLC | Clinic/Center | 166 Thompson Dr, Bridgeport, WV 26330-1644 | 2011-11-17 |
| 1588747166 | Nabil Guirguis | Clinic/Center | 166 Thompson Dr, Suite B, Bridgeport, WV 26330-1644 | 2006-10-24 |
| 1508831314 | Dva Healthcare Renal Care Inc | Clinic/Center | 900 Madison Ave, Ste 221, Bridgeport, CT 06606-5534 | 2006-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497961 | Saint Marina Home Dialysis LLC | Clinic/Center | 26711 Northwestern Hwy Ste 125, Southfield, MI 48033-2170 | 2020-11-05 |
| 1144820226 | Heritage Home Dialysis LLC | Clinic/Center | 1580 N Leroy St Ste 6, Fenton, MI 48430-2801 | 2020-10-28 |
| 1386262350 | Delta Renal Care Pllc | Clinic/Center | 3981 Elizabeth Ave, Canton, MI 48188-7223 | 2020-07-07 |
| 1457973257 | Fms Owosso, LLC | Clinic/Center | 918 Corunna Ave, Owosso, MI 48867-3768 | 2020-05-14 |
| 1023650926 | Falmont Dialysis LLC | Clinic/Center | 37290 5 Mile Rd, Livonia, MI 48154-1848 | 2019-10-11 |
| 1487112942 | Michigan Dialysis Services, LLC | Clinic/Center | 275 N Canton Center Rd, Canton, MI 48187 | 2019-03-04 |
| 1487123600 | Concerto Michigan LLC | Clinic/Center | 14700 Farmington Rd Ste 108, Livonia, MI 48154-5462 | 2018-11-16 |
| 1245715291 | Brooksprings Dialysis, LLC | Clinic/Center | 2391 Fifteen Mile Rd, Sterling Heights, MI 48310 | 2018-09-26 |
| 1851886592 | Fms Rochester Hills, LLC | Clinic/Center | 26400 W 12 Mile Rd Ste 112, Southfield, MI 48034-1785 | 2018-06-26 |
| 1801399753 | Kasaskia Dialysis LLC | Clinic/Center | 18001 E 10 Mile Rd Ste B, Roseville, MI 48066-3803 | 2018-03-16 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 48722 |
Please comment or provide details below to improve the information on BLAUVELT DIALYSIS LLC.
| 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.