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	11D2056132	OTHER	GA	CLIA
2	ESRD000703	OTHER	GA	ESRD PERMIT

General Provider Information

NPI Number	:	1922348366
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	:	615-320-4286
Fax Number	:	866-594-2893

Provider Business Practice Location Address
First Line	:	6225 ATLANTA HWY
Second Line	:	SUITE 117
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-8797
Country	:	US
Telephone Number	:	770-569-1275
Fax Number	:	770-475-1932

Authorized Official
Title or Position	:	CHIEF ACCOUNTING OFFICER
Name	:	MR. JAMES K HILGER
Credential	:
Telephone Number	:	253-733-4500

Provider Enumeration Date	:	02/21/2013
Last Update Date	:	09/27/2013

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Directions to “TOTAL RENAL CARE INC ” Practice Location

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