Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Atlanta 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
567 NORTH AVE NE, STE 200, ATLANTA, GA 30308-2721
(404) 853-1662
(404) 853-3674
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
ESRD001026
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000410374B
—
GA
05
—
890095700
—
FL
Enumeration date
03/14/2006
Last updated
09/25/2025
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