Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Northwood Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY VP LICENSURE & CERT (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
611 LEMOYNE RD, NORTHWOOD, OH 43619-1811
(419) 698-3423
(419) 698-5165
Mailing address
5200 VIRGINIA WAY, ATT: 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
0777DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2615094
—
OH
Enumeration date
04/14/2006
Last updated
09/03/2025
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