Organization
TOTAL RENAL CARE OF NORTH CAROLINA LLC
Active
Other names
New River 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
111 YOPP ROAD, JACKSONVILLE, NC 28540-3509
(910) 989-0157
(910) 989-0328
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912307596
—
NC
Enumeration date
09/02/2014
Last updated
06/17/2024
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