Organization
TOTAL RENAL CARE INC
Active
Other names
Beverlywood 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
2080 CENTURY PARK E, STE 210, LOS ANGELES, CA 90067-2001
(310) 772-0224
(310) 772-0120
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3085
(800) 268-9682
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
550003389
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306243209
—
CA
Enumeration date
11/21/2014
Last updated
02/12/2024
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