Organization
DVA HEALTHCARE OF NORWICH LLC
Active
Other names
Norwich 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
113 SALEM TPKE STE 4, NORWICH, CT 06360-6484
(860) 800-6388
(860) 800-6425
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
0279
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004206620
—
CT
Enumeration date
02/23/2006
Last updated
11/13/2024
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