Organization
TOTAL RENAL CARE INC
Active
Organization
TOTAL RENAL CARE INC
Active
Other names
Buckhead Home Training
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VICE PRESIDENT, LICENSURE & CERTIFI)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1575 NORTHSIDE DR NW, SUITE 355, ATLANTA, GA 30318-4210
(404) 352-1870
(404) 352-3107
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001275
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125298A
—
GA
01
—
11D2037095
CLIA
GA
Enumeration date
11/15/2011
Last updated
11/17/2023
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