Organization
RAI CARE CENTERS OF MICHIGAN I, LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
FMC-CLYDE PARK DIALYSIS
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
4893 CLYDE PARK AVE SW, WYOMING, MI 49509-5117
(616) 531-5353
(616) 531-5377
Mailing address
4893 CLYDE PARK AVE SW, WYOMING, MI 49509-5117
(616) 531-5353
(616) 531-5377
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
01
—
08949
BCBS
MI
01
—
09446
BCBS
MI
05
—
404836121
—
MI
Enumeration date
10/02/2006
Last updated
10/17/2023
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