Organization
DVA HEALTHCARE OF PENNSYLVANIA LLC
Active
Other names
Philadelphia PMC Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3823 MARKET ST, PHILADELPHIA, PA 19104-3145
(215) 222-0671
(215) 823-6949
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
—
1007451930024
—
PA
Enumeration date
04/08/2006
Last updated
07/16/2025
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