Organization
TOTAL RENAL CARE INC
Active
Other names
Jedburg 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
2897 W 5TH NORTH ST, SUMMERVILLE, SC 29483-9674
(843) 873-3955
(843) 873-0266
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
ERD-0183
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ERD-0236
—
SC
Enumeration date
10/12/2015
Last updated
10/17/2025
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