Organization
TOTAL RENAL CARE INC
Active
Other names
North Carrollton 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
195 PARKWOOD CIR, CARROLLTON, GA 30117-8756
(770) 832-8959
(770) 832-8796
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
ESRD000730
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003107287A
—
GA
01
—
11D2016474
CLIA
GA
Enumeration date
11/10/2010
Last updated
08/21/2024
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