Organization
DVA HEALTHCARE OF PENNSYLVANIA LLC
Active
Other names
Radnor Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
170 N HENDERSON RD, KING OF PRUSSIA, PA 19406-2155
(610) 337-6510
(610) 337-6516
Mailing address
5200 VIRGINIA WAY, L & C DEPT, BRENTWOOD, TN 37027-7569
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
—
1007451930022
—
PA
Enumeration date
04/05/2006
Last updated
02/18/2025
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