LAKELAND HOME PROGRAM LLC NPI 1184146789

NPI Information

  • NPI: 1184146789
  • Provider Name: LAKELAND HOME PROGRAM, LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: FRESENIUS MEDICAL CARE DIALYSIS SVC OF RANKIN COUNTY BRANDON
  • CLIA Number: 25D1007703
  • Address: 209 MAR LYN DR
    BRANDON, MS
    ZIP 39042
  • Phone: (601) 591-0053

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NPI Details

LAKELAND HOME PROGRAM, LLC is an end-stage renal disease (esrd) treatment clinic center in Brandon, MS. LAKELAND HOME PROGRAM, LLC NPI is 1184146789. The provider is registered as an organization entity type.
The provider Is Doing Business As Fresenius Medical Care Dialysis Svc Of Rankin County Brandon.

The provider's business location address is:

209 MAR LYN DR
BRANDON, MS
ZIP 39042-483
Phone: (601) 591-0053
Fax: (601) 591-0350

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 25D1007703 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2017 and was last updated on 10/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

What is NPI?

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This page was last updated on: 3/30/2025

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