Organization
TOTAL RENAL CARE INC
Active
Other names
West Bountiful Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
724 W 500 S, STE 300, WEST BOUNTIFUL, UT 84087
(801) 296-9091
(801) 296-9094
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6814
(800) 293-8405
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
2017-ESRD-928
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870570546015
—
UT
Enumeration date
04/14/2006
Last updated
07/15/2020
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