Organization
TOTAL RENAL CARE INC
Active
Other names
St Paul 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
555 PARK ST, STE 180, SAINT PAUL, MN 55103-2192
(651) 291-8855
(651) 291-0514
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
—
42054500
—
WI
05
—
594812600
—
MN
Enumeration date
04/14/2006
Last updated
09/12/2024
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