Organization
TOTAL RENAL CARE INC
Active
Other names
KELLEY CORNERS DIALYSIS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
231 KELLEY ST, LAKE CITY, SC 29560-2446
(843) 394-3847
(843) 394-3966
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RE0088
—
SC
Enumeration date
02/20/2017
Last updated
07/14/2021
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