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NPI Code Detail

MEDICARE: TOTAL RENAL CARE INC

MEDICARE: TOTAL RENAL CARE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center2785ESR8NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053373225
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOTAL RENAL CARE INC
Provider Business Mailing Address
First Line : 5200 VIRGINIA WAY
Second Line : STE 400
City : BRENTWOOD
State : TN
Zip : 37027-7569
Country : US
Telephone Number : 615-320-4435
Fax Number : 303-209-7821
Provider Business Practice Location Address
First Line : 330 S LOLA LN
Second Line :
City : PAHRUMP
State : NV
Zip : 89048-0884
Country : US
Telephone Number : 775-751-2390
Fax Number : 775-751-3708
Authorized Official
Title or Position : GROUP VICE PRESIDENT
Name : THOMAS O USILTON JR.
Credential :
Telephone Number : 770-541-7922
Provider Enumeration Date : 04/04/2006
Last Update Date : 02/18/2010

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Directions to “TOTAL RENAL CARE INC ” Practice Location

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