Organization
TOTAL RENAL CARE INC
Active
Other names
Maplewood Dialysis 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
2785 WHITE BEAR AVE N STE 201, MAPLEWOOD, MN 55109-1320
(651) 779-2222
(651) 779-9736
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
—
422527900
—
MN
Enumeration date
04/13/2006
Last updated
02/04/2025
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