Organization
LIBERTY DIALYSIS-SOUTHPOINTE LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
LIBERTY DIALYSIS-SOUTHPOINTE LLC
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
1200 CORPORATE DR, CANONSBURG, PA 15317-8576
(724) 745-5565
(724) 745-5567
Mailing address
1200 CORPORATE DR, CANONSBURG, PA 15317-8576
(724) 745-5565
(724) 745-5567
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
—
1013889520001
—
PA
01
—
392717
HIGHMARK SECURITY BLUE MC
—
Enumeration date
06/11/2006
Last updated
10/17/2023
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