FRESENIUS KIDNEY CARE TRAILBLAZER LLC NPI 1952886558

NPI Information

NPI: 1952886558
Provider Name: FRESENIUS KIDNEY CARE TRAILBLAZER, LLC

Doing Business As: CROCKETT DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
2001 E BOWIE AVE
CROCKETT, TX
ZIP 75835
Phone: (936) 546-0849
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FRESENIUS KIDNEY CARE TRAILBLAZER, LLC is an end-stage renal disease (esrd) treatment clinic center in Crockett, TX. FRESENIUS KIDNEY CARE TRAILBLAZER, LLC NPI is 1952886558. The provider is registered as an organization entity type.
The provider Is Doing Business As Crockett Dialysis Center.

The provider's business location address is:

2001 E BOWIE AVE
CROCKETT, TX
ZIP 75835-313
Phone: (936) 546-0849
Fax: (936) 545-8355

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 enumeration date for this NPI number is 9/28/2018 and was last updated on 10/16/2023.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

What is NPI?

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

NPI Synchronization or Removal

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