Provider Demographics
NPI:1902906951
Name:BIO-MEDICAL APPLICATIONS OF SAN GERMAN, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF SAN GERMAN, INC.
Other - Org Name:BMA SAN GERMAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:TORRE MEDICA SAN VICENTE DE PAUL HC3BOX26504
Mailing Address - Street 2:RD. 2, KM 173.4, BO. CAIN ALTO
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-0000
Mailing Address - Country:US
Mailing Address - Phone:787-892-4660
Mailing Address - Fax:787-892-3260
Practice Address - Street 1:TORRE MEDICA SAN VICENTE DE PAUL
Practice Address - Street 2:ROAD #2, KM 173.4, BO. CAIN ALTO
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-4660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
402506Medicare Oscar/Certification