Organization
TOTAL RENAL CARE INC
Active
Other names
Timpanogos Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1055 N 500 W STE 222, PROVO, UT 84604-3305
(801) 356-8907
(801) 356-2481
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
2018-ESRD-44948
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811139561
—
UT
Enumeration date
03/26/2009
Last updated
12/31/2025
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