Organization
TOTAL RENAL CARE INC
Active
Other names
Moccasin Creek 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
3313 SE 6TH AVE, ABERDEEN, SD 57401-5504
(605) 225-7344
(605) 225-1698
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
—
1437502614
—
SD
Enumeration date
07/22/2016
Last updated
12/16/2025
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