Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Christian County Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
200 BURLEY AVE, HOPKINSVILLE, KY 42240-8725
(270) 707-0701
(270) 707-0780
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
300140
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0182549
—
TN
05
—
3900030200
—
KY
Enumeration date
04/11/2006
Last updated
02/14/2025
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