Organization
TOTAL RENAL CARE INC
Active
Other names
Blue Mountain Kidney Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
72556 COYOTE RD, PENDLETON, OR 97801-1002
(541) 966-8563
(541) 966-8573
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
—
007148
—
OR
Enumeration date
03/26/2007
Last updated
09/17/2024
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