Organization
TOTAL RENAL CARE INC
Active
Other names
Myrtle Beach 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
3919 MAYFAIR ST, MYRTLE BEACH, SC 29577-5773
(843) 448-4920
(843) 448-4930
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
ERD-0163
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ERD163
—
SC
Enumeration date
05/19/2006
Last updated
07/07/2025
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