Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Brunswick Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY AO (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
53 SCRANTON CONNECTOR, BRUNSWICK, GA 31525-1862
(912) 264-8657
(912) 265-6542
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001131
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000410165A
—
GA
05
—
890065500
—
FL
Enumeration date
03/14/2006
Last updated
08/07/2025
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