Organization Name: | FRESENIUS MEDICAL CARE WEST FRANKFORT HOME, LLC |
NPI Number: | 1124457965 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK R FAWCETT (TREASURER) |
Mailing Address: | 5 W Frankfort Plz West Frankfort |
State: | IL US |
Postal Code: | 628964964 |
Phone Number: | 6189322643 |
Fax Number: | 6189322645 |
NPI Enumeration Date: | 11/02/2013 |
NPI Last Update Date: | 06/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |