Healthcare Provider Details
I. General information
NPI: 1386069367
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2014
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1140 S BEN MADDOX WAY
VISALIA CA
93292-3643
US
IV. Provider business mailing address
5200 VIRGINIA WAY L&C DEPT
BRENTWOOD TN
37027-7569
US
V. Phone/Fax
- Phone: 615-341-6789
- Fax:
- Phone: 615-341-6789
- Fax: 866-393-0702
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:
JAMES
K
HILGER
Title or Position: CHIEF ACCOUNTING OFFICER
Credential:
Phone: 253-733-4500