Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Ensley 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
2630 AVENUE E, BIRMINGHAM, AL 35218-2163
(205) 786-1371
(205) 786-5175
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
—
DIA2585D
—
AL
Enumeration date
02/08/2006
Last updated
08/20/2025
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