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FREDERICKTOWN DIALYSIS CLINIC
NPI 1639378474
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Fredericktown, MO

Active since July 12, 2007
105 ARMORY STREET, FREDERICKTOWN, MO 63645(573) 783-2089(573) 783-7206 Get Directions Write a Review

NPPES record last updated: August 15, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Fredericktown Dialysis Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FREDERICKTOWN DIALYSIS CLINIC (NPI 1639378474) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Fredericktown, Missouri and active in the NPI registry since July 2007. The organization lists Mark R. Fawcett, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1639378474
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameNRA FREDERICKTOWN MISSOURI LLC
Location Address105 ARMORY STREETFredericktown, MO 63645-1340
Mailing Address105 Armory StreetFredericktown, MO 63645-1340 · (573) 783-2089 · Fax (573) 783-7206
Phone(573) 783-2089
Fax(573) 783-7206
Organization SubpartYesParent: Fresenius Medical Care Holdings, Inc.
Authorized OfficialMark R. FawcettTreasurer · (781) 699-9000
Enumeration DateJuly 12, 2007
Last NPPES UpdateAugust 15, 2012
✔ NPI 1639378474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
License✔ Licensed in MO · NOT APPLICABLE
105 ARMORY STREET, Fredericktown, MO 63645
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Other Names 1

Doing Business AsFredericktown Dialysis Clinic

Other Identifiers 3

Medicaid504928904MO
Medicare OSCAR/certification262623MO
Other26D1071779MO · Clia Cert. Of Waiver

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nra Fredericktown Missouri LLC's NPI number?

The NPI number for Nra Fredericktown Missouri LLC is 1639378474. It was assigned to this organization in the NPPES registry on July 12, 2007. The provider is doing business as Fredericktown Dialysis Clinic.

Where is Nra Fredericktown Missouri LLC located?

Nra Fredericktown Missouri LLC is located at 105 Armory Street, Fredericktown, MO 63645. The listed phone number is (573) 783-2089.

What is Nra Fredericktown Missouri LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

When was this NPI record last updated?

The NPPES record for Nra Fredericktown Missouri LLC was last updated on August 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.