=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700234184
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOTAL RENAL CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2016
-----------------------------------------------------
Last Update Date | 10/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6530 W CAMPUS OVAL STE 100
-----------------------------------------------------
City | NEW ALBANY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43054-8726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-855-3445
-----------------------------------------------------
Fax | 614-855-9695
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5200 VIRGINIA WAY L&C DEPT
-----------------------------------------------------
City | BRENTWOOD
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37027-7569
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP LICENSURE & CERTIFICATION
-----------------------------------------------------
Name | SAMUEL T. WEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-341-6641
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QE0700X
-----------------------------------------------------
Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
-----------------------------------------------------
License Number | 1162DC
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------