NPI |
1306237854 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Entity Type Code |
2 |
The country code in the location address of the provider being identified. |
Employer Identification Number EIN |
|
The telephone number associated with the location address of the provider being identified. |
Provider Organization Name Legal Business Name |
TOTAL RENAL CARE INC |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Other Organization Name |
WANAMAKER DIALYSIS |
The date that a record was last updated or changed. |
Provider Other Organization Name Type Code |
3 |
The code designating the provider’s gender if the provider is a person. |
Provider First Line Business Practice Location Address |
3711 SW WANAMAKER RD |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider Business Practice Location Address City Name |
TOPEKA |
|
Provider Business Practice Location Address State Name |
KS |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
666101368 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
7852731824 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Fax Number |
7852731881 |
The fax number associated with the location
address of the provider being identified. |
Provider Enumeration Date |
2/5/2015 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Last Update Date |
6/24/2020 |
The date that a record was last updated or changed. |
Authorized Official Last Name |
WINSTEL |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official First Name |
JOHN |
The first name of the authorized official. |
Authorized Official Title or Position |
CHIEF ACCOUNTING OFFICER |
The title or position of the authorized official. |
Authorized Official Telephone Number |
2537334501 |
The 10-position telephone number of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
261QE0700X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Organization Subpart |
N |
|
NPI Certification Date |
6/24/2020 |
|