MEDICARE: TOTAL RENAL CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194146530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL RENAL CARE, INC.

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L&C DEPT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:	615-320-4593
Fax Number	:	800-293-5872

Provider Business Practice Location Address
First Line	:	14444 BEACH BLVD
Second Line	:	STE B
City	:	JACKSONVILLE
State	:	FL
Zip	:	32250-2010
Country	:	US
Telephone Number	:	904-992-9254
Fax Number	:	904-992-8835

Authorized Official
Title or Position	:	CHIEF ACCOUNTING OFFICER, TREASURER
Name	:	JOHN WINSTEL
Credential	:
Telephone Number	:	253-733-4501

Provider Enumeration Date	:	01/03/2014
Last Update Date	:	02/16/2021

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Directions to “TOTAL RENAL CARE, INC. ” Practice Location

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