Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Stamford 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
30 COMMERCE RD, STAMFORD, CT 06902-4550
(203) 358-9969
(203) 359-9252
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
0253
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004190691
—
CT
05
—
0072451
—
NJ
05
—
02215869
—
NY
Enumeration date
02/23/2006
Last updated
04/22/2026
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