Organization
TOTAL RENAL CARE INC
Active
Other names
Fleming Island 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
4575 US HIGHWAY 17 STE 301, FLEMING ISLAND, FL 32003-4825
(904) 215-2476
(904) 215-8344
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, 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
—
100914600
—
FL
Enumeration date
08/23/2017
Last updated
12/10/2024
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