Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Birmingham Home Training Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O USILTON JR. (GROUP VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
2101 7TH AVE SOUTH, BIRMINGHAM, AL 35233-3105
(205) 241-5105
(205) 322-5758
Mailing address
5200 VIRGINIA WAY, STE. 400 L&C DEPT., BRENTWOOD, TN 37027-7569
(615) 320-4218
(303) 209-7825
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
10770
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DIA2605D
—
AL
Enumeration date
02/07/2006
Last updated
07/11/2007
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