Organization
TOTAL RENAL CARE INC
Active
Other names
Palatka Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY AO (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
326 ZEAGLER DR, PALATKA, FL 32177-3817
(386) 329-9458
(386) 329-9340
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008713900
—
FL
Enumeration date
09/13/2012
Last updated
08/25/2023
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