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Organization

DVA HEALTHCARE RENAL CARE INC

Active
Other names
Pryor Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES K HILGER (VICE PRESIDENT)
(253) 382-1919
Entity
Organization

Contact information

Practice address
309 E GRAHAM AVE, PRYOR, OK 74361-2434
(918) 825-3100
(918) 825-3183
Mailing address
5200 VIRGINIA WAY, STE 400, BRENTWOOD, TN 37027-7569
(615) 320-4435
(866) 317-3596

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
100757220C
OK
Enumeration date
04/04/2006
Last updated
07/09/2008
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