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TOTAL RENAL CARE INC NPI 1710227822


NPI Information

NPI: 1710227822
Provider Name: TOTAL RENAL CARE INC

Doing Business As: CITY LINE DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
4508 CITY LINE AVE
PHILADELPHIA, PA
ZIP 19131
Phone: (215) 473-3071
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TOTAL RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Philadelphia, PA. TOTAL RENAL CARE INC NPI is 1710227822. The provider is registered as an organization entity type.
The provider Is Doing Business As City Line Dialysis.

The provider's business location address is:

4508 CITY LINE AVE
PHILADELPHIA, PA
ZIP 19131-509
Phone: (215) 473-3071
Fax: (215) 879-8305

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

The enumeration date for this NPI number is 2/26/2013 and was last updated on 6/17/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11007734290034MEDICAIDPENNSYLVANIA

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: 11/14/2023

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