Organization
TOTAL RENAL CARE INC
Active
Other names
Cass Lake Dialysis Facility
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
602 3RD ST NW, CASS LAKE, MN 56633-3395
(218) 335-4095
(218) 335-4188
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
—
226327100
—
MN
Enumeration date
04/18/2006
Last updated
07/24/2024
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