Organization
TOTAL RENAL CARE INC
Active
Other names
Gaston Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
5224 HIGHWAY 321, GASTON, SC 29053
(803) 796-7830
(803) 796-3458
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ERD-0205
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ERD-0205
STATE LICENSE
SC
05
—
RE0048
—
SC
Enumeration date
10/25/2012
Last updated
01/21/2021
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