Organization
TOTAL RENAL CARE INC
Active
Other names
Oak 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
8201 S HOWELL AVE, STE 600, OAK CREEK, WI 53154-8336
(414) 762-3784
(414) 762-4012
Mailing address
5200 VIRGINIA WAY, ATTN: 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
—
1508055997
—
WI
Enumeration date
10/22/2007
Last updated
05/15/2025
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