Healthcare Provider Details

I. General information

NPI: 1750345153
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 10/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 E COLLEGE DR STE 600
MARSHALL MN
56258-2065
US

IV. Provider business mailing address

5200 VIRGINIA WAY L&C DEPT
BRENTWOOD TN
37027-7569
US

V. Phone/Fax

Practice location:
  • Phone: 507-532-7393
  • Fax: 507-532-5776
Mailing address:
  • Phone: 615-320-4514
  • Fax: 866-594-9961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-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