Organization
TOTAL RENAL CARE INC
Active
Other names
University Dialysis Unit Riverside
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1045 WESTGATE DR STE 90, SAINT PAUL, MN 55114-1079
(651) 645-1847
(651) 645-1890
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01670
—
ND
05
—
1083678379
—
WI
05
—
228690400
—
MN
05
—
81697700
—
WI
Enumeration date
04/13/2006
Last updated
11/27/2024
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