Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Columbus East Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O USILTON JR. (GROUP VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
299 OUTERBELT ST, COLUMBUS, OH 43213-1529
(614) 501-7224
(614) 501-5197
Mailing address
5200 VIRGINIA WAY, STE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4521
(866) 594-2894
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0626DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2572630
—
OH
05
—
3900075700
—
KY
Enumeration date
04/13/2006
Last updated
04/14/2008
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