TOTAL RENAL CARE INC NPI 1376521930

NPI Information

NPI: 1376521930
Provider Name: TOTAL RENAL CARE INC

Doing Business As: CENTENNIAL ATLANTA DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
418 DECATUR ST SE
ATLANTA, GA
ZIP 30312
Phone: (404) 524-1606
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TOTAL RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Atlanta, GA. TOTAL RENAL CARE INC NPI is 1376521930. The provider is registered as an organization entity type.
The provider Is Doing Business As Centennial Atlanta Dialysis.

The provider's business location address is:

418 DECATUR ST SE
ATLANTA, GA
ZIP 30312-801
Phone: (404) 524-1606
Fax: (404) 525-3502

The provider's authorized official is John Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 11D0957850 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/4/2006 and was last updated on 1/7/2021.

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	ESRD001143	GEORGIA	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	000815559A	MEDICAID	GEORGIA

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: 5/5/2024

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