FRESENIUS PERRYVILLE OUTPATIENT DIALYSIS SERVICES CENTER, LLC


Address: 12 N Kingshighway St # 100, Perryville, MO 63775-1367
Phone: 5735472900

FRESENIUS PERRYVILLE OUTPATIENT DIALYSIS SERVICES CENTER, LLC (NPI# 1952413841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952413841
Entity Type Organization
Organization Name FRESENIUS PERRYVILLE OUTPATIENT DIALYSIS SERVICES CENTER, LLC
Other Organization Name PERRY COUNTY DIALYSIS CENTER
Practice Address 12 N Kingshighway St # 100
Perryville
MO 63775-1367
Practice Telephone 5735472900
Practice Fax Number 5735476024
Mailing Telephone 5735472900
Mailing Fax Number 5735476024
Enumeration Date 2006-08-31
Last Update Date 2012-10-12
Authorized Official Name MARK FAWCETT (TREASURER)
Authorized Official Telephone 7816999000
Is Organization Subpart Y
Parent Organization Name FRESENIUS MEDICAL CARE HOLDINGS, INC.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QE0700X Clinic/Center
Specialization: End-Stage Renal Disease (ESRD) Treatment
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
PERRY COUNTY DIALYSIS CENTER Doing Business As Name - Organization

Office Location

Street Address 12 N KINGSHIGHWAY ST # 100
City PERRYVILLE
State MO
Zip Code 63775-1367

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1710437603 Danielle Renee Hoeckele Chiropractor 1516 Edgemont Blvd Ste 100, Perryville, MO 63775 2016-10-04
1487024956 Sherry Ann Goshen Social Worker 12 N Kings Hwy, Perryville, MO 63775 2015-09-28
1669801353 Derek Adelman Physical Therapy Assistant 206 Hospital Lane, Ste 100, Perryville, MO 63775 2013-11-04
1407158678 Perry County Memorial Hospital Ambulance 434 N West Street, Perryville, MO 63775 2010-11-22
1699928358 East Missouri Action Agency, Inc. Clinic/Center 519 Old St Mary's Rd, Perryville, MO 63775 2008-10-28
1013171115 Air Evac Ems Inc. Ambulance 4801 N Highway 51, Perryville, MO 63775 2008-07-17
1245457241 Robert Schremp Physical Therapist 150 S. Mount Auburn Road, Cape Girardeau, MO 63775 2007-04-19
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Taxonomy Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

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1336748110 Westbrook Dialysis, LLC Clinic/Center 140 West Drive, Cape Girardeau, MO 63701 2020-10-22
1902415284 Fresenius Medical Care Creve Coeur Home Therapies, LLC Clinic/Center 450 N New Ballas Rd Ste 170, Creve Coeur, MO 63141-6835 2020-07-23
1730716085 Fresenius Medical Care Creve Coeur, LLC Clinic/Center 450 North New Bassas Road, Suite 180, Creve Coeur, MO 63141-6835 2020-03-26
1285109041 Branson Kidney Center LLC Clinic/Center 17829 Bus 13, Branson West, MO 65737 2018-10-09
1790271864 Dialysis Clinic Inc Clinic/Center 3101 W Broadway Ste 115, Columbia, MO 65203-0496 2018-07-02
1033602990 Lantell Dialysis LLC Clinic/Center 8608 E 63rd St, Kansas City, MO 64133-4725 2018-06-14
1851892731 Sparda Dialysis LLC Clinic/Center 40 Walters Pl, House Springs, MO 63051-1491 2018-02-26
1063923753 Isd Renal Inc Clinic/Center 1702 E 10th St Ste C, Rolla, MO 65401-4600 2017-10-20
1063923977 Total Renal Care Inc Clinic/Center 802 Jules St, St Joseph, MO 64501-1944 2017-10-18
1942710991 Washington University Clinic/Center 272 Mayfair Plaza Shopping Ctr, Florissant, MO 63033-8009 2017-10-04
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Competitor

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City PERRYVILLE
Zip Code 63775

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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