Organization
TOTAL RENAL CARE INC
Active
Other names
Pikes Peak Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2002 LELARAY ST STE 130, COLORADO SPRINGS, CO 80909-2804
(719) 471-4615
(719) 471-0621
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
0561
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09034773
—
NM
05
—
18089224
—
CO
Enumeration date
03/07/2006
Last updated
04/30/2024
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