Organization
TOTAL RENAL CARE INC
Active
Other names
North Glendale 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
1505 WILSON TER, STE 190, GLENDALE, CA 91206-4015
(818) 637-8348
(818) 637-8354
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
550000584
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629200134
—
CA
Enumeration date
08/17/2009
Last updated
02/28/2025
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