Organization
TOTAL RENAL CARE CRYSTAL RIVER DIALYSIS LC
Active
Other names
Crystal River 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
7435 W GULF TO LAKE HWY, CRYSTAL RIVER, FL 34429-7834
(352) 564-8400
(352) 564-0147
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212496300
—
FL
Enumeration date
03/02/2006
Last updated
02/27/2025
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