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NPI Code Detail

MEDICARE: TOTAL RENAL CARE INC

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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number : 1679906325
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOTAL RENAL CARE INC
Provider Business Mailing Address
First Line : 5200 VIRGINIA WAY
Second Line : ATT: L&C DEPT
City : BRENTWOOD
State : TN
Zip : 37027-7569
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3401 GLENDALE AVE STE 110
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2490
Country : US
Telephone Number : 419-389-9681
Fax Number : 419-389-9196
Authorized Official
Title or Position : VP, LICENSURE & CERTIFICATION
Name : SAMUEL T. WEY
Credential : AO
Telephone Number : 615-341-6641
Provider Enumeration Date : 08/16/2013
Last Update Date : 12/05/2024

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