Organization
TOTAL RENAL CARE INC
Active
Other names
Shiloh 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
1095 N GREEN MOUNT RD, BELLEVILLE, IL 62221-3303
(618) 628-1108
(618) 628-1459
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
Enumeration date
07/16/2012
Last updated
09/03/2024
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