Organization
TOTAL RENAL CARE INC
Active
Other names
Eastland 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
19101 E VALLEY VIEW PKWY, SUITE E, INDEPENDENCE, MO 64055-6907
(816) 795-6018
(816) 795-9572
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
—
1629269733
—
MO
Enumeration date
08/05/2007
Last updated
07/15/2025
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