Organization
DVA RENAL HEALTHCARE INC
Active
Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Central Little Rock Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY AO (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
6 FREEWAY DR, STE 100, LITTLE ROCK, AR 72204-2486
(501) 664-6754
(501) 296-9942
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
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
—
0042571
—
TN
05
—
02520061
—
MS
05
—
02529000
—
NY
05
—
1501611
—
LA
05
—
150329734
—
AR
05
—
503272502
—
MO
Enumeration date
02/10/2006
Last updated
07/20/2026
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