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TOTAL RENAL CARE OF NORTH CAROLINA LLC NPI 1003208240

NPI Profile

NPI: 1003208240
Provider Name: TOTAL RENAL CARE OF NORTH CAROLINA LLC

Doing Business As: SURF CITY DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 34D2097744

Address:
22807 US HIGHWAY 17 N
HAMPSTEAD, NC
ZIP 28443
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Phone: (910) 329-0706

TOTAL RENAL CARE OF NORTH CAROLINA LLC is an end-stage renal disease (esrd) treatment cliniccenter in Hampstead, NC. TOTAL RENAL CARE OF NORTH CAROLINA LLC NPI is 1003208240. The provider is registered as an organization entity type.
The provider Is Doing Business As Surf City Dialysis.

The provider's business location address is:

22807 US HIGHWAY 17 N
HAMPSTEAD, NC
ZIP 28443-178
Phone: (910) 329-0706
Fax: (910) 329-0841

The provider's authorized official is James K Hilger .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4500.

The CLIA number assigned to this NPI record is 34D2097744 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/25/2015 and was last updated on 12/5/2018.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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
11003208240MEDICAIDNORTH CAROLINA

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: 6/4/2020

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