Organization
DVA HEALTHCARE RENAL CARE, INC.
Active
Other names
Tallahassee 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
1607 PHYSICIANS DR, TALLAHASSEE, FL 32308-4620
(850) 878-8776
(850) 878-9004
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209491600
—
FL
Enumeration date
03/11/2006
Last updated
11/17/2025
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