Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Lawrenceburg Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER JR. (CHIEF ACCOUNTING OFFICER)
(931) 762-3136
Entity
Organization
Contact information
Practice address
2022 N LOCUST AVE, LAWRENCEBURG, TN 38464-2336
(931) 762-3136
(931) 762-6641
Mailing address
5200 VIRGINIA WAY, STE. 400 L&C, BRENTWOOD, TN 37027-7569
(615) 341-6657
(866) 651-9495
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
112
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442612
—
TN
Enumeration date
04/06/2006
Last updated
12/18/2013
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