Organization
DVA HEALTHCARE OF MASSACHUSETTS INC
Active
Other names
Woburn 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
23 WARREN AVE, WOBURN, MA 01801-7906
(781) 935-7700
(781) 933-7690
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
EJI6
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110028113H
—
MA
Enumeration date
03/20/2006
Last updated
01/20/2025
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