Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Abercorn Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY AO (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
11706 MERCY BLVD STE 9, SAVANNAH, GA 31419-1751
(912) 961-6006
(912) 961-9257
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
ESRD001082
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000893153K
—
GA
05
—
890572000
—
FL
05
—
ER0003
—
SC
Enumeration date
03/14/2006
Last updated
07/18/2025
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