Organization
TOTAL RENAL CARE INC
Active
Other names
Fountain Inn Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
298 CHAPMAN RD, FOUNTAIN INN, SC 29644-6129
(864) 862-2273
(864) 862-2465
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ERD0177
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RE0021
—
SC
Enumeration date
05/13/2010
Last updated
03/24/2026
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