Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Forest Hills Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1605 MEDICAL PARK DR W, WILSON, NC 27893-2799
(252) 265-0020
(252) 265-0645
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872
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
—
3402637
—
NC
Enumeration date
03/21/2006
Last updated
08/08/2023
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