Organization
TOTAL RENAL CARE INC
Active
Other names
Sheboygan 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
1338 N TAYLOR DR, SHEBOYGAN, WI 53081-3042
(920) 458-1724
(920) 458-1763
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
01
—
100024614
WI MEDICAID
WI
05
—
1124398052
—
WI
Enumeration date
01/10/2012
Last updated
02/02/2026
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