Organization
TOTAL RENAL CARE OF NORTH CAROLINA LLC
Active
Other names
Southeastern Dialysis Center - Shallotte
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4770 SHALLOTTE AVE, SHALLOTTE, NC 28470-6596
(910) 754-5563
(910) 754-5569
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
05
—
3422582
—
NC
Enumeration date
03/22/2006
Last updated
10/01/2025
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