Healthcare Provider Details
I. General information
NPI: 1457704637
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2016
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
519 MCCALL RD STE 100
MANHATTAN KS
66502-5038
US
IV. Provider business mailing address
5200 VIRGINIA WAY ATT: L&C DEPT
BRENTWOOD TN
37027-7569
US
V. Phone/Fax
- Phone: 785-539-5743
- Fax: 785-539-5781
- Phone:
- Fax:
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 | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
SAMUEL
T
WEY
Title or Position: VP, LICENSURE & CERTIFICATION
Credential:
Phone: 615-341-6641