Organization
TOTAL RENAL CARE INC
Active
Other names
Lake Hallie 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
3636 E MELBY ST, LAKE HALLIE, WI 54729-8392
(715) 833-8512
(715) 833-8534
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
Enumeration date
09/07/2012
Last updated
09/03/2024
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