Provider Demographics
NPI:1902108509
Name:FRESENIUS MEDICAL CARE COMPREHENSIVE CKD SERVICES INC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE COMPREHENSIVE CKD SERVICES INC
Other - Org Name:FMC CKD SERVICES OF EAST ORANGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:MILFORT
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APN-C
Authorized Official - Phone:908-241-0453
Mailing Address - Street 1:91-101 HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2833
Mailing Address - Country:US
Mailing Address - Phone:973-643-5404
Mailing Address - Fax:
Practice Address - Street 1:91-101 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2833
Practice Address - Country:US
Practice Address - Phone:973-643-5404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00156900363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty