Organization
DVA RENAL HEALTHCARE INC
Active
Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Memphis University Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O USILTON JR. (GROUP VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
1391 MADISON AVE, MEMPHIS, TN 38104-2326
(901) 725-5399
(901) 725-0838
Mailing address
5200 VIRGINIA WAY, STE. 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4218
(303) 209-7825
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
99
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00220626
—
MS
05
—
0442523
—
TN
Enumeration date
04/07/2006
Last updated
08/22/2020
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