Organization
DVA HEALTHCARE RENAL CARE, INC
Active
Other names
East Rome 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
1401 DEAN ST SE, SUITE H, ROME, GA 30161-6494
(706) 232-9890
(706) 232-0144
Mailing address
5200 VIRGINIA WAY, SUITE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4218
(615) 320-4487
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD
GA
Other
Enumeration date
03/14/2006
Last updated
08/22/2020
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