Organization
TOTAL RENAL CARE INC
Active
Other names
Maple Valley Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
649 MAPLE VALLEY DR, FARMINGTON, MO 63640-1993
(573) 747-0946
(573) 747-0536
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588990303
—
MO
Enumeration date
10/29/2009
Last updated
09/24/2024
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