Organization
TOTAL RENAL CARE INC
Active
Other names
St. John Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
10033 WICKER AVE STE 6, SAINT JOHN, IN 46373-8777
(219) 365-5043
(219) 365-5385
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(833) 781-7005
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
—
200911110 A
—
IN
Enumeration date
05/27/2008
Last updated
09/19/2018
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