TOTAL RENAL CARE INC NPI 1235191859

NPI Information

NPI: 1235191859
Provider Name: TOTAL RENAL CARE INC

Doing Business As: BOLIVAR DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
515 PECAN DR
BOLIVAR, TN
ZIP 38008
Phone: (731) 658-3828
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TOTAL RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Bolivar, TN. TOTAL RENAL CARE INC NPI is 1235191859. The provider is registered as an organization entity type.
The provider Is Doing Business As Bolivar Dialysis.

The provider's business location address is:

515 PECAN DR
BOLIVAR, TN
ZIP 38008-611
Phone: (731) 658-3828
Fax: (731) 659-2840

The provider's authorized official is Samuel 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 44D0926028 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/6/2006 and was last updated on 3/26/2024.

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	88	TENNESSEE	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	0442601	MEDICAID	TENNESSEE

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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