Organization
DVA RENAL HEALTHCARE INC
Active
Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Memphis Central 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
889 DR ML KING JR AVE, MEMPHIS, TN 38126-1928
(901) 525-1719
(901) 525-0341
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
114
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00220603
—
MS
05
—
0442573
—
TN
05
—
122406134
—
AR
05
—
202020921
—
MD
05
—
202020921
—
MO
05
—
502928013
—
MO
Enumeration date
04/06/2006
Last updated
12/12/2025
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