Organization
TOTAL RENAL CARE INC
Active
Other names
Gem State Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAM T WEY (SR DIRECTOR LICENSURE/CERTIFICATION)
(615) 341-6691
Entity
Organization
Contact information
Practice address
2225 TETON PLZ STE A, IDAHO FALLS, ID 83404-6494
(208) 715-9570
(208) 715-9850
Mailing address
5200 VIRGINIA WAY, L&C DEPT., BRENTWOOD, TN 37027-7569
(615) 341-6814
(800) 293-8405
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
11/09/2023
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