Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Candler County Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
325 CEDAR ST, METTER, GA 30439-4043
(912) 225-9849
(912) 225-9850
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001078
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000709233C
—
GA
Enumeration date
03/14/2006
Last updated
08/09/2024
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