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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/CenterESRD000756GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
211D1100178OTHERGACLIA

General Provider Information

NPI Number : 1992941736
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 : 615-928-3545
Fax Number : 833-214-6980
Provider Business Practice Location Address
First Line : 4434 HUGH HOWELL RD
Second Line :
City : TUCKER
State : GA
Zip : 30084-4905
Country : US
Telephone Number : 770-491-7187
Fax Number : 770-491-7192
Authorized Official
Title or Position : VP LICENSURE & CERTIFICATION
Name : SAMUEL WEY
Credential :
Telephone Number : 615-341-6641
Provider Enumeration Date : 12/29/2008
Last Update Date : 02/20/2025

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