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Organization

DVA HEALTHCARE RENAL CARE INC

Active
Other names
Tipton 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
107 TENNESSEE AVE, COVINGTON, TN 38019-3902
(901) 475-0410
(901) 475-9040
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
48
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0442604
TN
05
05774858
MS
05
3900014600
KY
Enumeration date
04/07/2006
Last updated
09/23/2025
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