Organization
DVA WASHINGTON UNIVERSITY HEALTHCARE OF GREATER ST LOUIS LLC
Active
Parent organization
DAVITA INC
Other names
Village Square Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVITA INC
Authorized official
SAM T WEY (VP, LICENSURE AND CERTIFICATION)
(615) 341-6691
Entity
Organization
Contact information
Practice address
1 VILLAGE SQUARE SHOPPING CENTER, SUITE 1, HAZELWOOD, MO 63042-1817
(314) 252-7110
Mailing address
5200 VIRGINIA WAY, LICENSURE AND CERTIFICATION DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
04/13/2026
Last updated
04/13/2026
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