Organization
TOTAL RENAL CARE INC
Active
Other names
Eastern Boulevard 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
246 EASTERN BLVD N STE 105, HAGERSTOWN, MD 21740-6666
(301) 745-4251
(301) 797-4637
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
E2691
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4235517 00
—
MD
Enumeration date
08/06/2014
Last updated
06/02/2025
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