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
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1073871760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL RENAL CARE INC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L&C DEPARTMENT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:	615-238-3051
Fax Number	:	800-246-8346

Provider Business Practice Location Address
First Line	:	1487 N HIGH ST
Second Line	:	STE 1A
City	:	HILLSBORO
State	:	OH
Zip	:	45133-8496
Country	:	US
Telephone Number	:	937-393-9020
Fax Number	:	937-393-9095

Authorized Official
Title or Position	:	CHIEF ACCOUNTING OFFICER
Name	:	JAMES K HILGER
Credential	:
Telephone Number	:	253-733-4500

Provider Enumeration Date	:	05/01/2012
Last Update Date	:	04/26/2019

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