Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Brentwood 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
1231 BRENTWOOD RD NE, WASHINGTON, DC 20018-1019
(202) 636-3711
(202) 636-3769
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, 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
—
00925195
—
VA
05
—
033659900
—
DC
05
—
355551800
—
MD
Enumeration date
02/24/2006
Last updated
11/18/2024
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