Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Walterboro 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
302 RUBY ST, WALTERBORO, SC 29488-2758
(843) 549-6743
(843) 549-5228
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
ERD-0113
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425285
—
SC
Enumeration date
04/05/2006
Last updated
11/26/2025
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