Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Hopkinsville Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
115 N VIRGINIA ST, HOPKINSVILLE, KY 42240-3143
(270) 887-5622
(270) 886-9784
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
300056
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508822
—
TN
05
—
3900004700
—
KY
Enumeration date
04/10/2006
Last updated
03/26/2025
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