Organization
TOTAL RENAL CARE INC
Active
Other names
Lodi Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1610 W KETTLEMAN LN STE D, LODI, CA 95242-4210
(209) 334-9888
(209) 333-0888
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
110000465
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528027349
—
CA
Enumeration date
03/21/2006
Last updated
03/10/2025
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