Organization
TOTAL RENAL CARE INC
Active
Other names
Coon Rapids Dialysis Unit, Mississippi Gateway 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
3960 COON RAPIDS BLVD NW STE 309, COON RAPIDS, MN 55433-2589
(763) 421-8717
(763) 421-4789
Mailing address
5200 VIRGINIA WAY, ATT: 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
—
827826100
—
MN
Enumeration date
04/13/2006
Last updated
10/13/2025
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