Provider Demographics
NPI:1447470513
Name:BIO-MEDICAL APPLICATIONS OF TENNESSEE, INC.
Entity type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF TENNESSEE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:193 BROWN JUNCTION LANE
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37033-1344
Mailing Address - Country:US
Mailing Address - Phone:931-729-0810
Mailing Address - Fax:931-729-0811
Practice Address - Street 1:193 BROWN JUNCTION LANE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37033-1344
Practice Address - Country:US
Practice Address - Phone:931-729-0810
Practice Address - Fax:931-729-0811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-30
Last Update Date:2018-09-20
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
TN442675Medicare Oscar/Certification