Healthcare Provider Details

I. General information

NPI: 1770817454
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 HAMRA ST
TIPTONVILLE TN
38079-1663
US

IV. Provider business mailing address

5200 VIRGINIA WAY L&C DEPT 4TH FLOOR
BRENTWOOD TN
37027-7569
US

V. Phone/Fax

Practice location:
  • Phone: 731-253-6279
  • Fax:
Mailing address:
  • Phone: 615-341-6789
  • Fax: 866-393-0702

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: 253-382-1919