Organization
TOTAL RENAL CARE INC
Active
Other names
US Grant 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
458 HOME ST, GEORGETOWN, OH 45121-1408
(937) 378-1323
(937) 378-5130
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3051
(800) 246-8346
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
—
2932812
—
OH
01
—
=========
TRICARE
—
Enumeration date
05/05/2008
Last updated
11/15/2023
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