Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
South Yuma 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
7179 E 31ST PL, YUMA, AZ 85365-8392
(928) 317-0517
(928) 726-9155
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
OTC762
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197865
—
AZ
05
—
XCDC00540
—
CA
Enumeration date
02/09/2006
Last updated
05/30/2024
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