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Total Renal Care Inc

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Cudahy, CA

NPI 1073576153 · NPPES record last updated Jan 21, 2025

Key facts

NPI
1073576153
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
930000867 (CA)
Legal business name
TOTAL RENAL CARE INC
Practice address
7612 Atlantic Ave
Cudahy, CA 90201-5020
Phone
(323) 562-5511
Fax
(323) 562-3347
NPI assigned
Apr 10, 2006
Organization subpart
No

Authorized official

Name
Samuel T. Wey
Title
VP, Licensure & Certification
Phone
(615) 341-6641

Corporate family (same tax ID) 23

Organizations that report the same tax identification number in the National Provider Directory.

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Dialysis facility

Listed as
DaVita Premier Dialysis Center CCN 052761
Overall star rating
★★★☆☆ 3.0 of 5
Ownership
Profit
Certified
Apr 11, 1995
Medicare certification status
Active (Provider of Services file)
Chain
DaVita
Dialysis stations
36

Source: Medicare Care Compare. Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0897386Premier Dialysis Center
7612 Atlantic Avenue, Cudahy, CA 90201		Certificate of waiverJan 31, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080103000772 CA Part a Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Cudahy, CA

National Provider Directory

Tax ID family
Davita Upstate Dialysis (758 organizations share this tax ID)

Locations

7612 Atlantic Ave
Cudahy, CA 90201
Phone (323) 562-5511

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 930000867 CA Yes

Addresses

Primary practice location

7612 Atlantic Ave
Cudahy, CA 90201-5020

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers

IdentifierTypeStateIssuer
1073576153MedicaidCA

Other names

  • Premier Dialysis Center Doing business as

Other providers in Cudahy, CA

All providers in Cudahy, CA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.