Organization
TOTAL RENAL CARE INC
Active
Other names
Premier Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
7612 ATLANTIC AVE, CUDAHY, CA 90201-5020
(323) 562-5511
(323) 562-3347
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
930000867
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073576153
—
CA
Enumeration date
04/10/2006
Last updated
01/21/2025
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