Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Crestview Hills 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
400 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3478
(859) 341-5561
(859) 341-5746
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
300102
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3900019500
—
KY
Enumeration date
04/10/2006
Last updated
08/14/2025
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