Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Dothan 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
216 GRACELAND DR, DOTHAN, AL 36305-7346
(334) 793-4077
(334) 793-2404
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
S3501
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DIA2506D
—
AL
Enumeration date
02/08/2006
Last updated
12/19/2023
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