Organization
NRA ADA OKLAHOMA LLC
Active
Organization
NRA ADA OKLAHOMA LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
Ada Dialysis Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Authorized official
MARK R FAWCETT (TREASURER)
(781) 699-9000
Entity
Organization
Contact information
Practice address
324 NW J.A. RICHARDSON LOOP, ADA, OK 74820-2017
(580) 421-9131
(580) 421-9135
Mailing address
324 NW J A RICHARDSON LOOP, ADA, OK 74820-2017
(580) 421-9131
(580) 421-9135
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
N/A
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200100430A
—
OK
01
—
37D1049560
CLIA CERTIFICATE OF WAIVE
OK
Enumeration date
06/01/2006
Last updated
06/05/2014
Update your record
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