Total Renal Care Inc
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · St George, UT
NPI 1619630571 · NPPES record last updated Sep 26, 2024
Key facts
- NPI
- 1619630571
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- TOTAL RENAL CARE INC
- Practice address
- 720 S River Rd Ste D1100
St George, UT 84790-5522 - Phone
- (435) 523-4375
- Fax
- (435) 523-4376
- NPI assigned
- Oct 18, 2021
- Organization subpart
- No
Authorized official
- Name
- Samuel Wey
- Title
- VP Licensure & Certification
- Phone
- (615) 341-6641
Corporate family (same tax ID) 15
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211116002578 | UT | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 0749473072 | Practice locations: St George, UT |
National Provider Directory
- Tax ID family
- Davita Upstate Dialysis
Locations
720 S River Rd
St George, UT 84790
Phone (435) 251-5980
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
720 S River Rd Ste D1100
St George, UT 84790-5522
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other names
- Dixie Dialysis
Other providers in St George, UT
- Benjamin Torres
- Jazmine Torres
- Maribel Torres
- Sarahi Torres
- Tyler Max Torres
- Total Respiratory Care Inc
- Amanda Towe
- Teresa Town
- Kaytlin Faith Townes
- Willie C Townsend III
All providers in St George, UT · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.