Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Clarksville Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
231 HILLCREST DR, CLARKSVILLE, TN 37043-5093
(931) 645-9694
(931) 647-5517
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
108
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442556
—
TN
05
—
3900002100
—
KY
Enumeration date
04/06/2006
Last updated
02/12/2025
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