Organization
LIBERTY DIALYSIS PETERSBURG, LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
LIBERTY DIALYSIS PETERSBURG 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
3400 S CRATER RD, PETERSBURG, VA 23805-9252
(804) 732-8228
(804) 732-8288
Mailing address
3400 S CRATER RD, PETERSBURG, VA 23805-9252
(804) 732-8228
(804) 732-8288
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
—
195526
ANTHEM BCBS OF VA
—
Enumeration date
08/14/2006
Last updated
10/17/2023
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