Organization
TOTAL RENAL CARE INC
Active
Other names
Waconia Dialysis Facility
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
490 S MAPLE ST, SUITE 110, WACONIA, MN 55387-1760
(952) 442-1572
(952) 442-2053
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4435
(303) 209-7821
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
712725100
—
MN
Enumeration date
04/13/2006
Last updated
12/20/2013
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