Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Elizabeth City Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
1840 W CITY DR, ELIZABETH CITY, NC 27909-9632
(252) 338-2217
(252) 338-4051
Mailing address
5200 VIRGINIA WAY, ATT: 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
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578522314
—
VA
05
—
3412515
—
NC
Enumeration date
03/21/2006
Last updated
05/31/2023
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