Organization
TOTAL RENAL CARE INC
Active
Other names
Jacksonville Westside 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
5276 BLANDING BLVD, STE 26, JACKSONVILLE, FL 32210-8176
(904) 573-6405
(904) 908-9975
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101591600
—
FL
Enumeration date
10/05/2016
Last updated
03/13/2025
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