Organization
DVA HEALTHCARE OF MASSACHUSETTS INC
Active
Other names
Shrewsbury Street Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
267 SHREWSBURY ST, WORCESTER, MA 01604-4623
(774) 530-6353
(774) 530-6348
Mailing address
5200 VIRGINIA WAY, L & C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4214
(866) 944-3352
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
—
110028113
—
MA
Enumeration date
09/24/2017
Last updated
03/15/2024
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