Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Anthem Village 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
2530 ANTHEM VILLAGE DR, HENDERSON, NV 89052-5548
(702) 614-0590
(702) 614-7419
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504175
—
NV
Enumeration date
04/04/2006
Last updated
06/02/2025
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