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Organization

RENAL CARE GROUP OF THE SOUTHEAST, INC.

Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
FRESENIUS KIDNEY CARE CRESTVIEW
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
223 E REDSTONE AVE, CRESTVIEW, FL 32539-5373
(850) 603-6295
(850) 603-6300
Mailing address
223 E REDSTONE AVE, CRESTVIEW, FL 32539-5373
(850) 603-6295
(850) 603-6300

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
200496801
FL
Enumeration date
08/31/2006
Last updated
10/16/2023
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