Organization
DVA HEALTHCARE OF PENNSYLVANIA LLC
Active
Other names
Waynesburg Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
248 ELM DR, WAYNESBURG, PA 15370-8269
(724) 627-3997
(724) 627-5305
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0403000000
—
WV
05
—
1007451930014
—
PA
05
—
2222802
—
OH
Enumeration date
04/06/2006
Last updated
01/15/2026
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