Organization
TOTAL RENAL CARE INC
Active
Other names
Northern Star 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
311 ELM ST, WOODRUFF, WI 54568-9149
(715) 356-0132
(715) 356-6392
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
—
1841589199
—
WI
Enumeration date
04/06/2011
Last updated
01/10/2025
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