Organization
TOTAL RENAL CARE INC
Active
Other names
Antelope Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O USILTON JR. (GROUP VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
6406 TUPELO DR, #A, CITRUS HEIGHTS, CA 95621-1741
(916) 721-1800
(916) 721-4376
Mailing address
5200 VIRGINIA WAY, STE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4435
(303) 209-7821
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC02663G
—
CA
Enumeration date
03/20/2006
Last updated
09/26/2007
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