Organization
COLUMBUS RNA DAVITA LLC
Active
Other names
Columbus Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
226 GRACELAND BLVD, STE 3-09A, COLUMBUS, OH 43214-1532
(614) 985-1732
(614) 781-0906
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0556DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2908241
—
OH
Enumeration date
04/17/2008
Last updated
05/13/2024
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