Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Cobbs Creek Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
1700 S 60TH ST, PHILADELPHIA, PA 19142-1404
(215) 730-0500
(215) 730-0600
Mailing address
5200 VIRGINIA WAY, L & C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6410
(888) 662-8259
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
—
1007635580083
—
PA
05
—
8451605
—
NJ
Enumeration date
04/04/2006
Last updated
11/17/2020
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