Organization
BENTONVILLE DIALYSIS
Active
Organization
BENTONVILLE DIALYSIS
Active
Other names
Total Renal Care Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KENT THIRY CHAIRMAN (CEO)
(303) 876-6000
Entity
Organization
Contact information
Practice address
1423 PACIFIC AVE, TACOMA, WA 98402-4203
(253) 382-1752
Mailing address
1104 SE 30TH ST, BENTONVILLE, AR 72712-4290
(479) 657-6220
(479) 657-6229
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
04D0922944
AR
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
1306024294
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168262134
—
AR
Enumeration date
04/07/2014
Last updated
04/07/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up