Organization
TOTAL RENAL CARE INC
Active
Other names
Dialysis Center of Middle Georgia-Macon
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2494 2ND ST, MACON, GA 31206
(478) 464-1872
(478) 464-0792
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
ESRD001048
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000619561M
—
GA
01
—
ESRD001048
STATE LICENSE
GA
Enumeration date
03/14/2006
Last updated
01/09/2025
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