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Organization

DVA RENAL HEALTHCARE INC

Active
Other names
Memphis East Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
6029 WALNUT GROVE RD, STE C003, MEMPHIS, TN 38120-2110
(901) 747-2316
(901) 747-0634
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
115
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00220604
MS
05
0442576
TN
05
139633134
AR
05
202020921
MD
05
202020921
MO
05
502928039
MO
Enumeration date
04/06/2006
Last updated
10/04/2023
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