Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Springfield Montvale Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2930 MONTVALE DR, STE A, SPRINGFIELD, IL 62704-5376
(217) 793-2781
(217) 793-2845
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
—
—
Other
Enumeration date
03/17/2006
Last updated
09/24/2024
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