Organization
DVA HEALTHCARE RENAL CARE, INC.
Active
Other names
Union County Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
615 COMFORT LN, MONROE, NC 28112-5599
(704) 225-0944
(704) 225-9233
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325268
—
SC
05
—
3412526
—
NC
Enumeration date
03/21/2006
Last updated
02/25/2025
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