1770172645 NPI number — FRESENIUS VASCULAR CARE DAYTON LLC

Table of content: (NPI 1770172645)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770172645 NPI number — FRESENIUS VASCULAR CARE DAYTON LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRESENIUS VASCULAR CARE DAYTON LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770172645
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 412924
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02241-2924
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-644-8900
Provider Business Mailing Address Fax Number:
484-924-0053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2016 SPRINGBORO W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORAINE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45439-1648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-298-6777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2021

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
GREGG
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
717-515-4048

Provider Taxonomy Codes

  • Taxonomy code: 2085R0204X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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