Organization · Type 2 NPI

Nra Fredericktown Missouri LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Fredericktown, MO

NPI number 1639378474 Active

Practice location

105 Armory Street
Fredericktown, MO 63645-1340

Call (573) 783-2089 Map

Fax (573) 783-7206

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	NOT APPLICABLE (MO)

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

NPI record

NPI: 1639378474
Entity type: Organization (Type 2)
Issued: Jul 12, 2007
Last updated: Aug 15, 2012
Status: Active
Subpart: Yes of Fresenius Medical Care Holdings, Inc.

Other names

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Fredericktown Dialysis Clinic · doing business as

Authorized official

Mr. Mark R. Fawcett
Treasurer
(781) 699-9000

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639378474

Nra Fredericktown Missouri LLC's National Provider Identifier is 1639378474, issued on Jul 12, 2007. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Fredericktown, MO. The record was last updated on Aug 15, 2012.