Organization
TOTAL RENAL CARE INC
Active
Other names
South Jackson 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
46 HARTS BRIDGE RD, JACKSON, TN 38301-7512
(731) 422-9568
(731) 422-9556
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
—
1526374
—
TN
01
—
208
STATE LICENSE
TN
Enumeration date
02/28/2011
Last updated
01/27/2026
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