Organization
DVA RENAL HEALTHCARE INC
Active
Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Los Angeles Downtown Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIR LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2021 S FLOWER ST, LOS ANGELES, CA 90007-1342
(213) 745-4222
(213) 749-1753
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3085
(800) 268-9682
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
930000911
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013981984
—
CA
05
—
843210
—
AZ
Enumeration date
02/15/2006
Last updated
08/09/2023
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