Organization
DVA HEALTHCARE RENAL CARE, INC.
Active
Other names
West Tallahassee 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
5857 W TENNESSEE ST, TALLAHASSEE, FL 32304-9218
(850) 350-0002
(850) 350-0120
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
—
000855709A
—
GA
05
—
000855709B
—
GA
05
—
200518202
—
FL
Enumeration date
03/11/2006
Last updated
03/18/2026
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