Organization
TOTAL RENAL CARE, INC.
Active
Other names
Bull Run Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
9420 FORESTWOOD LN, STE 100, MANASSAS, VA 20110-4757
(703) 257-1749
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730569849
—
VA
Enumeration date
06/03/2015
Last updated
07/11/2025
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