Organization
DVA HEALTHCARE RENAL CARE INC
Active
Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Yuma 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
2130 W 24TH ST, YUMA, AZ 85364-6122
(928) 783-2365
(928) 783-6870
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
OTC3619
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032502
MEDICARE
AZ
05
—
061218
—
AZ
Enumeration date
02/10/2006
Last updated
08/27/2026
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