Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Dearborn Home Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 280-9501
Entity
Organization
Contact information
Practice address
22030 PARK ST, DEARBORN, MI 48124-2854
(313) 792-7343
(313) 792-8341
Mailing address
5200 VIRGINIA WAY, STE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4200
(615) 320-4487
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
—
1689833956
—
MI
Enumeration date
06/03/2008
Last updated
08/16/2012
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