Organization
DVA HEALTHCARE OF MARYLAND LLC
Active
Other names
Falls Road 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
1423 CLARKVIEW RD, STE 500, BALTIMORE, MD 21209-2189
(410) 828-4643
(410) 823-8305
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
E2588
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007727620013
—
PA
05
—
210900000
—
MD
Enumeration date
03/27/2006
Last updated
05/05/2025
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