Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Northumberland 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
10932 W STATE ROUTE 61, MOUNT CARMEL, PA 17851-2575
(570) 339-5558
(570) 339-5997
Mailing address
5200 VIRGINIA WAY, 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
—
1007635580102
—
PA
Enumeration date
04/05/2006
Last updated
02/22/2024
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