Organization
TOTAL RENAL CARE INC
Active
Other names
East River Road 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
5301 E RIVER RD STE 117, FRIDLEY, MN 55421
(763) 571-5556
(763) 571-7882
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
—
237105000
—
MN
Enumeration date
06/29/2007
Last updated
12/19/2024
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