Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
North Ridge Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER, TREASURER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
6830 N RIDGE RD, MADISON, OH 44057-2637
(440) 428-8377
(440) 428-0615
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3051
(800) 246-8346
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0526DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007635580121
—
PA
05
—
2120869
—
OH
Enumeration date
04/13/2006
Last updated
01/22/2021
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