Provider Demographics
NPI: | 1922419704 |
---|---|
Name: | TOTAL RENAL CARE INC |
Entity type: | Organization |
Organization Name: | TOTAL RENAL CARE INC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF ACCOUNTING OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JAMES |
Authorized Official - Middle Name: | K |
Authorized Official - Last Name: | HILGER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 253-733-4500 |
Mailing Address - Street 1: | 5200 VIRGINIA WAY |
Mailing Address - Street 2: | LICENSURE AND CERTIFICATION DEPT |
Mailing Address - City: | BRENTWOOD |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37027-7569 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 615-341-6657 |
Mailing Address - Fax: | 866-651-9495 |
Practice Address - Street 1: | 993 E DIVISION ST STE A |
Practice Address - Street 2: | |
Practice Address - City: | COAL CITY |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60416-9483 |
Practice Address - Country: | US |
Practice Address - Phone: | 815-634-0820 |
Practice Address - Fax: | 815-634-0844 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-05-14 |
Last Update Date: | 2014-05-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QE0700X | Ambulatory Health Care Facilities | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment |