Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Coshocton 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
1404 CHESTNUT ST, COSHOCTON, OH 43812-1401
(740) 623-2917
(740) 623-8455
Mailing address
5200 VIRGINIA WAY, STE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4435
(303) 209-7821
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0717DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2464480
—
OH
Enumeration date
04/13/2006
Last updated
08/14/2007
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