Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
West Philadelphia Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
7609 LINDBERGH BLVD, PHILADELPHIA, PA 19153-2301
(215) 937-1103
(215) 937-0770
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
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010024625
—
VA
05
—
1007635580130
—
PA
05
—
8452903
—
NJ
Enumeration date
04/10/2006
Last updated
06/05/2024
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