Organization
TOTAL RENAL CARE INC
Active
Other names
Longs Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR,LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
90 CLOVERLEAF DR, STE 306, LONGS, SC 29568-9262
(843) 582-0582
(843) 582-0448
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ERD-0185
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RE0015
—
SC
Enumeration date
03/20/2008
Last updated
08/11/2023
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