Organization
NRA-CROSSVILLE, TENNESSEE, LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
Crossville Dialysis Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Authorized official
BARRY BLANTON (VICE PRESIDENT)
(781) 699-9000
Entity
Organization
Contact information
Practice address
121 DOOLEY ST, CROSSVILLE, TN 38555-4075
(931) 484-4500
(931) 484-2130
Mailing address
121 DOOLEY ST, CROSSVILLE, TN 38555-4075
(931) 484-4500
(931) 484-2130
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0000000148
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442656
—
TN
01
—
44D1034070
CLIA CERTIFICATE OF WAIVE
TN
Enumeration date
05/30/2006
Last updated
10/17/2023
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