Organization
TOTAL RENAL CARE INC
Active
Other names
Cypress Gardens 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
418 BROAD ST, SUMTER, SC 29150
(803) 418-5129
(803) 418-0722
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, 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
01
—
ERD-0220
STATE LICENSE
SC
05
—
RE0071
—
SC
Enumeration date
01/02/2015
Last updated
11/25/2024
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