Organization
RENAL CARE GROUP OF THE SOUTHEAST, INC.
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
RENAL CARE GROUP FT. WALTON BEACH
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Authorized official
BARRY L. BLANTON (VICE PRESIDENT)
(781) 699-9000
Entity
Organization
Contact information
Practice address
925 MAR WALT DR STE 3, FORT WALTON BEACH, FL 32547-6609
(850) 864-4411
(850) 864-1279
Mailing address
925 MAR WALT DR STE 3, FORT WALTON BEACH, FL 32547-6609
(850) 864-4411
(850) 864-1279
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212067400
—
FL
Enumeration date
08/31/2006
Last updated
10/16/2023
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