Organization
TOTAL RENAL CARE INC
Active
Other names
Vidalia First Street 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
906 E 1ST ST, VIDALIA, GA 30474-4207
(912) 538-8908
(912) 538-8909
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
ESRD001220
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000972529C
—
GA
Enumeration date
07/17/2008
Last updated
02/26/2025
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