Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Eufaula Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
220 S ORANGE AVE, EUFAULA, AL 36027-1612
(334) 688-0806
(334) 688-9893
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
S0302
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065136545A
—
GA
05
—
DIA2609D
—
AL
Enumeration date
02/09/2006
Last updated
10/17/2024
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