Organization
DVA HEALTHCARE RENAL CARE INC
Active
Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Aiken Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY AO (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
775 MEDICAL PARK DR, AIKEN, SC 29801-6306
(803) 641-4222
(803) 641-4224
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ERD-0034
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000855709K
—
GA
05
—
425123
—
SC
Enumeration date
04/04/2006
Last updated
09/25/2023
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