Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Cumming Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
911 MARKET PLACE BLVD, STE 3, CUMMING, GA 30041
(678) 513-6486
(678) 947-5446
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001174
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000880129A
—
GA
Enumeration date
03/14/2006
Last updated
01/26/2021
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