TOTAL RENAL CARE INC NPI 1235457508

NPI Information

  • NPI: 1235457508
  • Provider Name: TOTAL RENAL CARE INC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: BAY SHORE DIALYSIS
  • CLIA Number: 52D2011695
  • Address: 5650 N GREEN BAY AVE
    SUITE 150
    GLENDALE, WI
    ZIP 53209
  • Phone: (414) 351-1290

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NPI Details

TOTAL RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Glendale, WI. TOTAL RENAL CARE INC NPI is 1235457508. The provider is registered as an organization entity type.
The provider Is Doing Business As Bay Shore Dialysis.

The provider's business location address is:

5650 N GREEN BAY AVE
SUITE 150
GLENDALE, WI
ZIP 53209-449
Phone: (414) 351-1290
Fax: (414) 351-1244

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 52D2011695 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/12/2010 and was last updated on 11/21/2024.

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
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
11235457508MEDICAIDWISCONSIN

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: 11/21/2025

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