EAST RIVER ROAD DIALYSIS – NPI #1740487057
Clinic/Center

EAST RIVER ROAD DIALYSIS is an AHC clinic located in FRIDLEY, MN. NPPES has assigned the NPI number 1740487057 to EAST RIVER ROAD DIALYSIS on June 29, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “EAST RIVER ROAD DIALYSIS” is a dba name, the actual legal business name for this organization is TOTAL RENAL CARE INC. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was last updated on Dec 19, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EAST RIVER ROAD DIALYSIS below.

NPI Profile for
TOTAL RENAL CARE INC

NPI Number
1740487057
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
TOTAL RENAL CARE INC
Doing Business As (dba): EAST RIVER ROAD DIALYSIS
Primary location
5301 E RIVER RD STE 117
FRIDLEY, MN 55421
Phone: (763) 571-5556 Fax: (763) 571-7882
Mailing address
5200 VIRGINIA WAY
L&C DEPT
BRENTWOOD, TN 37027-7569
Phone: Fax:
Organization Subpart
No
Authorized Official
SAMUEL WEY
VP LICENSURE & CERTIFICATION
Phone: (615) 341-6641
Updated
Certification Date
Dec 19, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for EAST RIVER ROAD DIALYSIS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidMN237105000
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.