Organization
TOTAL RENAL CARE INC
Active
Other names
Maysville 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
489 TUCKER DR, MAYSVILLE, KY 41056-9111
(606) 759-0923
(606) 759-4915
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPARTMENT, 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
—
2861452
—
OH
05
—
7100029920
—
KY
Enumeration date
05/21/2007
Last updated
12/30/2024
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