Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Charlotte East 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
5627 ALBEMARLE RD, CHARLOTTE, NC 28212-3611
(704) 535-3962
(704) 531-4878
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872
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
—
3402627
—
NC
Enumeration date
03/22/2006
Last updated
03/19/2024
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