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Organization

DVA HEALTHCARE RENAL CARE INC

Active
Other names
East Atlanta 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
1308 MORELAND AVE SE, ATLANTA, GA 30316-3224
(404) 627-5511
(404) 627-5522
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4286
(866) 594-2893

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001140
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000685451A
GA
Enumeration date
03/14/2006
Last updated
10/14/2015
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