Organization
TOTAL RENAL CARE INC
Active
Other names
Menomonee Falls 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
N87W17301 MAIN ST, MENOMONEE FALLS, WI 53051-2760
(262) 253-9768
(262) 253-9870
Mailing address
5200 VIRGINIA WAY, ATT: 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
—
1376084731
—
WI
Enumeration date
03/17/2017
Last updated
05/21/2024
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