Organization
TOTAL RENAL CARE INC
Active
Other names
Grand Junction Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
710 WELLINGTON AVE, SUITE 20, GRAND JUNCTION, CO 81501
(970) 263-8573
(970) 245-4398
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
121105
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962518753
—
CO
Enumeration date
08/22/2006
Last updated
10/15/2024
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