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Organization

DVA HEALTHCARE RENAL CARE INC

Active
Other names
Wyncote 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
1000 EASTON RD, STE 250, WYNCOTE, PA 19095-2934
(215) 884-3398
(215) 884-3424
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6410
(888) 662-8259

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
1007635580012
PA
Enumeration date
04/04/2006
Last updated
02/08/2024
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