Organization
TOTAL RENAL CARE INC
Active
Other names
Jesse Jewell 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
1475 JESSE JEWELL PKWY NE, STE 110, GAINESVILLE, GA 30501-3806
(770) 538-7598
(770) 538-7632
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPARTMENT, 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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003205233A
—
GA
Enumeration date
10/03/2017
Last updated
01/04/2024
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