Organization
TOTAL RENAL CARE INC
Active
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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