Organization
TOTAL RENAL CARE INC
Active
Other names
Clarksville North 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
3071 CLAY LEWIS RD, CLARKSVILLE, TN 37040-5141
(931) 552-0644
(931) 552-6036
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
166
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442672
—
TN
05
—
7100030770
—
KY
Enumeration date
06/28/2007
Last updated
09/25/2024
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