Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Palm Springs 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
1061 N INDIAN CANYON DR, PALM SPRINGS, CA 92262-4854
(760) 325-0909
(760) 320-1723
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000800
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639143431
—
CA
Enumeration date
02/16/2006
Last updated
12/10/2024
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