Provider Type Icon

FRESENIUS MEDICAL CARE FORT WAYNE LLC NPI 1104247154


NPI Information

NPI: 1104247154
Provider Name: FRESENIUS MEDICAL CARE FORT WAYNE, LLC

Doing Business As: FRESENIUS MEDICAL CARE TRI-COUNTIES

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 15D0917513

Address:
817 S 13TH ST
DECATUR, IN
ZIP 46733
Phone: (260) 724-8303
Get Directions

FRESENIUS MEDICAL CARE FORT WAYNE, LLC is an end-stage renal disease (esrd) treatment clinic center in Decatur, IN. FRESENIUS MEDICAL CARE FORT WAYNE, LLC NPI is 1104247154. The provider is registered as an organization entity type.
The provider Is Doing Business As Fresenius Medical Care Tri-counties.

The provider's business location address is:

817 S 13TH ST
DECATUR, IN
ZIP 46733-891
Phone: (260) 724-8303
Fax: (260) 724-7685

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 15D0917513 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/18/2013 and was last updated on 10/17/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.