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Organization

DVA HEALTHCARE RENAL CARE INC

Active
Other names
Ahoskie Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
129 HERTFORD COUNTY HIGH RD, AHOSKIE, NC 27910-8131
(252) 332-3896
(252) 332-3971
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872

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
003425703
VA
05
3402570
NC
Enumeration date
03/22/2006
Last updated
08/25/2023
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