Organization
TOTAL RENAL CARE INC
Active
Other names
West Bloomfield Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
6010 W MAPLE RD STE 215, WEST BLOOMFIELD, MI 48322-4406
(248) 539-1025
(248) 539-2986
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPARTMENT, 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
—
1558518423
—
MI
Enumeration date
01/03/2011
Last updated
11/27/2024
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