Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Fairfield Home Training Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
1210 HICKS BLVD, FAIRFIELD, OH 45014-1921
(513) 939-1120
(513) 939-1150
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3051
(800) 246-8346
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0497DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2220279
—
OH
05
—
3900037700
—
KY
Enumeration date
04/13/2006
Last updated
09/18/2019
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