TOTAL RENAL CARE INC NPI 1245294545

NPI Information

NPI: 1245294545
Provider Name: TOTAL RENAL CARE INC

Doing Business As: WOODBURY DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1850 WEIR DR
STE 3
WOODBURY, MN
ZIP 55125
Phone: (651) 730-4522
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TOTAL RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Woodbury, MN. TOTAL RENAL CARE INC NPI is 1245294545. The provider is registered as an organization entity type.
The provider Is Doing Business As Woodbury Dialysis.

The provider's business location address is:

1850 WEIR DR
STE 3
WOODBURY, MN
ZIP 55125-260
Phone: (651) 730-4522
Fax: (651) 730-5089

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 24D0928607 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/13/2006 and was last updated on 11/2/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	42055100	MEDICAID	WISCONSIN
2	449513600	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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