Organization
TOTAL RENAL CARE INC
Active
Other names
Medlock Bridge Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
10680 MEDLOCK BRIDGE RD, STE 103, DULUTH, GA 30097-8420
(770) 622-2167
(770) 622-5542
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
ESRD000794
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000619561S
—
GA
Enumeration date
10/02/2006
Last updated
04/29/2025
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