Organization
DVA HEALTHCARE RENAL CARE INC
Active
Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Greater Daytona Home Training Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER JR. (VICE PRESIDENT)
(253) 382-1919
Entity
Organization
Contact information
Practice address
575 N CLYDE MORRIS BLVD, STE A, DAYTONA BEACH, FL 32114-2323
(386) 258-7719
(386) 258-7524
Mailing address
5200 VIRGINIA WAY, STE 400, BRENTWOOD, TN 37027-7569
(615) 320-4218
(303) 209-7825
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
—
200518221
—
FL
Enumeration date
03/08/2006
Last updated
07/20/2010
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