Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Salem North Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
1220 LIBERTY ST NE, SALEM, OR 97303-7330
(503) 315-2212
(503) 315-2199
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6814
(800) 293-8405
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
170050
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297033
—
OR
05
—
3990520
—
WA
Enumeration date
04/04/2006
Last updated
11/05/2021
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