Organization
TOTAL RENAL CARE INC
Active
Other names
O'Fallon Missouri Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAM T WEY (VP LICENSURE AND CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4663 HIGHWAY K, O FALLON, MO 63368-8690
(636) 324-1617
(636) 321-0483
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386879898
—
MO
Enumeration date
05/28/2009
Last updated
11/07/2024
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