Organization · Type 2 NPI

Total Renal Care Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Lake Hallie, WI

NPI number 1508115395 Active

Practice location

3636 E Melby St
Lake Hallie, WI 54729-8392

Call (715) 833-8512 Map

Fax (715) 833-8534

Mailing address

5200 Virginia Way, Attn: L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

NPI record

NPI: 1508115395
Entity type: Organization (Type 2)
Issued: Sep 7, 2012
Last updated: Sep 3, 2024
Status: Active

Other names

<unavail>
Lake Hallie Dialysis · doing business as
Lake Hallie Dialysis · doing business as

Authorized official

Samuel T Wey
VP Licensure & Certification
(615) 341-6641

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About NPI 1508115395

Total Renal Care Inc's National Provider Identifier is 1508115395, issued on Sep 7, 2012. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Lake Hallie, WI. The record was last updated on Sep 3, 2024.