Total Renal Care Inc
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Salt Lake City, UT
NPI 1750046686 · NPPES record last updated Sep 30, 2024
Key facts
- NPI
- 1750046686
- 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
- 423 S Wakara Way Ste 200
Salt Lake City, UT 84108-3534 - Phone
- (385) 433-3146
- Fax
- (385) 433-3152
- NPI assigned
- Nov 4, 2021
- Organization subpart
- No
Authorized official
- Name
- Samuel Wey
- Title
- VP Licensure & Certification
- Phone
- (615) 341-6641
Corporate family (same tax ID) 13
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211122001143 | UT | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 0749473072 | Practice locations: Salt Lake City, UT |
National Provider Directory
- Tax ID family
- Davita Upstate Dialysis
Locations
423 S Wakara Way
Salt Lake City, UT 84108
Phone (406) 580-4641
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
423 S Wakara Way Ste 200
Salt Lake City, UT 84108-3534
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other names
- Kolff Dialysis
Other providers in Salt Lake City, UT
- Jared Tortosa
- Cristhian V. Toruno
- Leah Tosches
- Eleanor Toslosky
- Total Care Solutions LLC
- Emerald Anne Catherine Toth
- Robert Toth
- Jacquelyn L Toton
- Charity Macel Totten-Beal
- Touchstone Therapy Center
All providers in Salt Lake City, 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 30, 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.