TOTAL RENAL CARE INC NPI 1417911918

NPI Information

NPI: 1417911918
Provider Name: TOTAL RENAL CARE INC

Doing Business As: WYOMING DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 24D0920748

Address:
5657 257TH ST
WYOMING, MN
ZIP 55092
Phone: (651) 408-8938
Get Directions

TOTAL RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Wyoming, MN. TOTAL RENAL CARE INC NPI is 1417911918. The provider is registered as an organization entity type.
The provider Is Doing Business As Wyoming Dialysis.

The provider's business location address is:

5657 257TH ST
WYOMING, MN
ZIP 55092-068
Phone: (651) 408-8938
Fax: (651) 462-8176

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

The CLIA number assigned to this NPI record is 24D0920748 - 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 8/31/2023.

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	017814400	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: 5/5/2024

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