Organization
INNOVATIVE DIALYSIS CENTERS OF LA GRANGE, LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
Fresenius Kidney Care La Grange Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Authorized official
BARRY L. BLANTON (VP)
(781) 699-9000
Entity
Organization
Contact information
Practice address
1300 LAFAYETTE PKWY, SUITE D, LAGRANGE, GA 30241-2612
(706) 884-3765
(706) 884-5304
Mailing address
1300 LAFAYETTE PKWY STE D, LAGRANGE, GA 30241-2610
(781) 419-0182
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
—
003146669A
—
GA
Enumeration date
04/12/2013
Last updated
10/23/2023
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