Organization
TOTAL RENAL CARE, INC.
Active
Other names
St. Augustine Home Training
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
252 SOUTHPARK CIR E, SAINT AUGUSTINE, FL 32086-5137
(904) 823-1594
(904) 808-1437
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
—
013885600
—
FL
Enumeration date
05/02/2014
Last updated
05/21/2024
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