Organization
TOTAL RENAL CARE INC
Active
Other names
TRC Pine City
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
129 6TH AVE SE, LAKESIDE MEDICAL CENTER, PINE CITY, MN 55063-1913
(763) 444-7245
(763) 444-3997
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3119
(877) 338-0295
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
—
542812200
—
MN
05
—
82811400
—
WI
Enumeration date
04/13/2006
Last updated
05/04/2017
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