Healthcare Provider Details
I. General information
NPI: 1740244714
Provider Name (Legal Business Name): TOTAL RENAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/14/2006
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
280 N HATCHER AVE
PURCELLVILLE VA
20132-3193
US
IV. Provider business mailing address
5200 VIRGINIA WAY L & C DEPT
BRENTWOOD TN
37027-7569
US
V. Phone/Fax
- Phone: 540-338-1501
- Fax: 540-338-1506
- Phone: 800-467-4736
- Fax: 615-320-4487
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: GROUP VICE PRESIDENT
Credential:
Phone: 253-733-4500