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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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