Organization
TOTAL RENAL CARE INC
Active
Other names
Fort Mill 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
1975 CAROLINA PLACE DR, FORT MILL, SC 29708-6922
(803) 802-3027
(803) 802-0319
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-0167
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ERD-0167
STATE LICENSE
SC
05
—
ERD167
—
SC
Enumeration date
05/17/2006
Last updated
05/15/2025
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