Organization
TOTAL RENAL CARE INC
Active
Organization
TOTAL RENAL CARE INC
Active
Other names
Bentonville 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
1104 SE 30TH ST, BENTONVILLE, AR 72712-4290
(479) 657-6220
(479) 657-6229
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
—
100757230C
—
OK
05
—
1317675
—
LA
05
—
168262134
—
AR
Enumeration date
02/04/2008
Last updated
08/13/2026
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