Organization
TOTAL RENAL CARE INC
Active
Other names
Sikeston Jaycee Regional 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
135 PLAZA DR, STE 101, SIKESTON, MO 63801-5148
(573) 472-7230
(573) 472-7214
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
—
1255638839
—
MO
Enumeration date
02/17/2011
Last updated
05/15/2025
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