Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Bloomfield 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
29 GRIFFIN RD S, BLOOMFIELD, CT 06002-1351
(860) 243-5389
(860) 243-8150
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0275
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004238467
—
CT
Enumeration date
02/23/2006
Last updated
11/12/2025
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