Organization
DVA HEALTHCARE SOUTHWEST OHIO LLC
Active
Other names
Winton Road Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
6550 WINTON RD, CINCINNATI, OH 45224-1327
(513) 591-2900
(513) 591-0208
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3051
(800) 246-8346
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0523DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2120994
—
OH
05
—
3900017900
—
KY
Enumeration date
04/14/2006
Last updated
12/06/2023
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