Healthcare Provider Details
I. General information
NPI: 1548639792
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/17/2015
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8331 BRIMHALL RD STE 902 BLDG 900
BAKERSFIELD CA
93312-2249
US
IV. Provider business mailing address
5200 VIRGINIA WAY L&C DEPT
BRENTWOOD TN
37027-7569
US
V. Phone/Fax
- Phone: 661-387-6405
- Fax: 661-387-6015
- Phone: 615-341-6793
- Fax: 877-790-2174
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
D.
WINSTEL
Title or Position: CHIEF ACCOUNTING OFFICER
Credential:
Phone: 253-733-4501