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NPI Code Detail

MEDICARE: TOTAL RENAL CARE OF COLORADO INC

MEDICARE: TOTAL RENAL CARE OF COLORADO 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/Center0845CO

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 : 1255308235
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOTAL RENAL CARE OF COLORADO 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 : 1750 PIERCE ST
Second Line : STE B
City : LAKEWOOD
State : CO
Zip : 80214-1434
Country : US
Telephone Number : 303-238-6111
Fax Number : 303-462-0946
Authorized Official
Title or Position : GROUP VICE PRESIDENT
Name : THOMAS O USILTON JR.
Credential :
Telephone Number : 770-541-7922
Provider Enumeration Date : 03/08/2006
Last Update Date : 07/11/2007

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Directions to “TOTAL RENAL CARE OF COLORADO INC ” Practice Location

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