Basic Information
Provider Information
NPI: 1669584405
EntityType: 2
ReplacementNPI:  
OrganizationName: BIO-MEDICAL APPLICATIONS OF LOUISIANA, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: FLORIDA PARISHES ARTIFICIAL KIDNEY CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16081 DOCTORS BLVD
Address2:  
City: HAMMOND
State: LA
PostalCode: 704031479
CountryCode: US
TelephoneNumber: 9853455621
FaxNumber: 9853455622
Practice Location
Address1: 16081 DOCTORS BLVD
Address2:  
City: HAMMOND
State: LA
PostalCode: 704031479
CountryCode: US
TelephoneNumber: 9853455621
FaxNumber: 9853455622
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 08/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BLANTON
AuthorizedOfficialFirstName: BARRY
AuthorizedOfficialMiddleName: L.
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 7816999000
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: FRESENIUS MEDICAL CARE HOLDINGS, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QE0700X  Y Ambulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment

No ID Information.


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