Organization
TOTAL RENAL CARE INC
Active
Parent organization
DAVITA INC
Other names
Rice Lake Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVITA INC
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1700 W STOUT ST, RICE LAKE, WI 54868-5000
(715) 236-6159
(715) 236-6522
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
—
—
Other
Enumeration date
12/29/2021
Last updated
08/15/2024
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