Organization
BAY AREA MEDICAL CENTER INC
Active
Other names
Bay Area Medical Center Inc Dialysis Unit
Organization subpart
No
Provider details
NPI number
Authorized official
C DANIAL CARLSON CPA (CFO)
(715) 735-8016
Entity
Organization
Contact information
Practice address
3100 SHORE DRIVE, MARINETTE, WI 54143-4242
(715) 735-4200
(715) 735-1791
Mailing address
3100 SHORE DRIVE, MARINETTE, WI 54143-4242
(715) 735-4200
(715) 735-1791
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
—
11001400
—
WI
05
—
1711544TYPE40
—
MI
Enumeration date
11/01/2006
Last updated
04/29/2008
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