Organization
NRA LONDON KENTUCKY LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
London Dialysis Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Authorized official
MR. MARK R. FAWCETT (TREASURER)
(781) 699-9000
Entity
Organization
Contact information
Practice address
775 N LAUREL RD, LONDON, KY 40741-6025
(606) 862-8888
(606) 862-8890
Mailing address
775 N LAUREL RD, SUITE 500, LONDON, KY 40741-6025
(606) 862-8888
(606) 862-8890
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
330159
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18D1010862
CLIA CERT OF WAIVER
KY
05
—
39000617
—
KY
Enumeration date
01/13/2006
Last updated
07/22/2015
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